Peripheral neuropathy in chronic disease of the respiratory tract (original) (raw)
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National Journal of Medical Research, 2015
Objective: To know the frequency and predictors of peripheral neuropathy and the abnormal visual evoked potentials in stable patients with chronic obstructive pulmonary disease. Material & Methods: All consecutive patients of stable COPD of age ≥ 40 years were screened for peripheral neuropathy. Total 57 patients of stable COPD of age ≥ 40 Years were selected. Spirometric examination was done in all the patients using an electronic portable based spirometer with printer. Neuro-physiological evaluation (neurological disability score-NDS), Mini Mental State Examination-questionnaire (MMSE), Visual analogue scale (VAS) were done on all subjects. The following nerves were evaluated for latency, amplitude, and conduction velocity. For motor nerve conduction: - median, ulnar, common peroneal and tibial nerves were evaluated. For sensory nerve conduction: - median, ulnar and sural nerves were evaluated. VEP was evaluated in all the 57 subjects. The continuous variables were described using means and analysis was done using independent t test. Results: Sub-clinical neuropathy was seen in 28 (49%) out of 57 stable COPD patients. Sensory neuropathy was seen in majority of patients. Sural nerve was the most commonly involved nerve. Neuropathy was predominantly axonal in nature. Abnormal VEP was found in 18 (32%) patients in whom P100 latency was more than 107. Conclusions: Electro-physiological testing showed the presence of peripheral neuropathy in 49% patients and abnormal VEP in 32% patients with stable COPD, who had no neurological symptoms. Maximum number of stable COPD patients with severe obstruction, heavy smoking index and bio-mass exposure had peripheral neuropathy, but statistically this was not found significant.
Peripheral neuropathy: A neglected cause of disability in COPD – A narrative review
Respiratory Medicine
Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory syndrome with systemic involvement leading to various cardiovascular, metabolic, and neurological comorbidities. It is well known that conditions associated with oxygen deprivation and metabolic disturbance are associated with polyneuropathy, but current data regarding the relationship between COPD and peripheral nervous system pathology is limited. This review summarizes the available data on the association between COPD and polyneuropathy, including possible pathophysiological mechanisms such as the role of hypoxia, proinflammatory state, and smoking in nerve damage; the role of cardiovascular and metabolic comorbidities, as well as the diagnostic methods and screening tools for identifying polyneuropathy. Furthermore, it outlines the available options for managing and preventing polyneuropathy in COPD patients. Overall, current data suggest that optimal screening strategies to diagnose polyneuropathy early should be implemented in COPD patients due to their relatively common association and the additional burden of polyneuropathy on quality of life.
Respiratory insufficiency in neuronopathic and neuropathic disorders
QJM, 1996
Twenty-nine patients with a neuronopathic or neuropathic disorder were referred for assessment of respiratory insufficiency between 1978 and 1994. Diagnoses included spinal muscular atrophy (6), chronic idiopathic demyelinating neuropathy (4), Vialetto-van Laere syndrome (3), hereditary motor and sensory neuropathy (3) and a miscellaneous group (5). We also describe seven patients with Guillain-Barre syndrome (GBS) who required longterm ventilatory support for over 6 months to 7 years after the initial illness. Respiratory insufficiency occurred as a consequence of respiratory muscle weakness, impaired bulbar function and restrictive lung defects. In some groups presentation was with progressive nocturnal hypoventilation culminating in acute respiratory failure. Five patients with GBS or chronic idiopathic demyelinating neuropathy were weaned from ventilatory support up to 18 months after the initial illness. The remaining 24 patients required continuous or nocturnal ventilatory support using intermittent positive-pressure ventilation (13), negative pressure ventilation (4), nasal-mask-delivered intermittent positive-pressure ventilation (4), nasal-maskdelivered continuous positive-pressure ventilation (3), mouthpiece-assisted ventilation by day (2) and rocking bed (1). None have been weaned from support after a period of ventilation ranging from one month to 10 years. Eight patients have subsequently died.
Chronic obstructive pulmonary disease and peripheral neuropathy
Lung India, 2006
Background The relationship between chronic obstructive pulmonary disease (COPD) and periprocedural complications of percutaneous coronary interventions (PCIs) is influenced by several factors. We aimed to investigate the association between COPD, its complication type and rate in patients undergoing PCI. Methods Data were prospectively collected using the Polish Cardiovascular Intervention Society national registry (ORPKI) on all PCIs performed in Poland between January 2015 and December 2016. COPD was present in 5,594 of the 221,187 patients undergoing PCI. We assessed the frequency and predictors of periprocedural complications in PCI. Results Patients with COPD were elder individuals (70.3 ± 9.9 vs. 67 ± 10.8 years; p < 0.05). We noted 145 (2.6%) periprocedural complications in the COPD group and 4,121 (1.9%) in the non-COPD group (p < 0.001). The higher incidence of periprocedural complications in the COPD patients was mainly attributed to cardiac arrest (p = 0.001), myocardial infarctions (p = 0.002) and no-reflows (p < 0.001). COPD was not an independent predictor of all periprocedural complications. On the other hand, COPD was found to be an independent predictor of increased no-reflow risk (odds ratio [OR] 1.447, 95% CI 1.085-1.929; p = 0.01), and at the same time, of decreased risk of periprocedural allergic reactions (OR 0.117, 95% CI 0.016-0.837; p = 0.03).
2016
SUMMARY Nineteen patients with chronic respiratory insufficiency, mean age 61-4 + 12-2, have been investigated with pulmonary function tests, clinical neurological examination and neurophysiological methods including motor and sensory conduction studies and needle elec-tromyography. None of them had conditions known to affect the peripheral nervous system such as diabetes, alcoholism, or uraemia. The motor and sensory conduction studies showed only a reduced mean amplitude of the ulnar nerve SAP and of the compound muscle action potential of the APB and EDB muscles. The EMG was abnormal in 94-7 % of the cases and showed an increased percentage of polyphasic potentials and a reduced recruitment pattern of motor units firing at high frequency. The data seem to support the hypothesis of an involvement of motor neurons in this condition although the evidence for a neuropathy is lacking. While the effects of chronic respiratory insufficiency on the central nervous system are well known,&...
Evidence of motor neuron involvement in chronic respiratory insufficiency
Journal of Neurology, Neurosurgery & Psychiatry, 1984
Nineteen patients with chronic respiratory insufficiency, mean age 61-4 + 12-2, have been investigated with pulmonary function tests, clinical neurological examination and neurophysiological methods including motor and sensory conduction studies and needle electromyography. None of them had conditions known to affect the peripheral nervous system such as diabetes, alcoholism, or uraemia. The motor and sensory conduction studies showed only a reduced mean amplitude of the ulnar nerve SAP and of the compound muscle action potential of the APB and EDB muscles. The EMG was abnormal in 94-7% of the cases and showed an increased percentage of polyphasic potentials and a reduced recruitment pattern of motor units firing at high frequency. The data seem to support the hypothesis of an involvement of motor neurons in this condition although the evidence for a neuropathy is lacking.
Archives of Medical Science, 2012
Introduction: Chronic obstructive pulmonary diseases (COPD) have some systemic effects including systemic inflammation, nutritional abnormalities, skeletal muscle dysfunction, and cardiovascular, skeletal and neurological disorders. Some studies have reported the presence of peripheral neuropathy (PNP) at an incidence of 28-94% in patients with COPD. Our study aimed to identify whether PNP affects exercise performance and quality of life in COPD patients. Material and methods: Thirty mild-very severe patients with COPD (male/female = 29/1, mean age = 64 ±10 years) and 14 normal subjects (male/female = 11/5, mean age = 61 ±8 years) were included in the present study. All subjects underwent pulmonary function testing (PFT), cardiopulmonary exercise testing, electroneuromyography and short form 36 (SF-36). Results: Peak oxygen uptake (PeakVO 2) was lower in COPD patients (1.15 ±0.53 l/min) than healthy subjects (2.02 ±0.46 l/min) (p = 0.0001). There was no PNP in healthy subjects while 16 (53%) of the COPD patients had PNP. Forced expiratory volume in 1 s (FEV 1) and PeakVO 2 were significantly different between patients with PNP and those without (p = 0.009, p = 0.03 respectively). Quality of life of patients with PNP was lower than that of patients without PNP (p < 0.05). Conclusions: The present study demonstrates the exercise limitation in COPD patients with PNP. Thus, presence of PNP has a poor effect on exercise capacity and quality of life in patients with COPD. Furthermore, treatment modalities for PNP can be recommended to these patients in order to improve exercise capacity and quality of life.
2007
Neuromuscular diseases affect alveolar air exchange and therefore cause chronic respiratory failure. The onset of respiratory failure can be acute, as in traumas, or progressive (slow or rapid), as in amyotrophic lateral sclerosis, muscular dystrophies, diseases of the myoneural junction, etc. Respiratory muscle impairment also affects cough efficiency and, according to the current knowledge regarding the type of treatment available
The European Research Journal, 2018
Objective. Chronic Obstructive Pulmonary Disease (COPD) is accompanied by several concomitant conditions due to its systemic effects. Hypoxia and oxidative stress associated with COPD are also believed to contribute to the disease course through the effects of several inflammatory mediators. Major causative agents causing of peripheral neuropathy are age, hypoxia, duration and severity of COPD, hypercapnia and smoking. The present study aimed to investigate the incidence of polyneuropathy and its relation with disease parameters in COPD patients. Methods. Of a total number of 45 patients who had been followed up between January 1, 2015 and December 31, 2016 with a diagnosis of COPD at Ufuk University School of Medicine were enrolled retrospectively. All patients underwent electroneuromyography, arterial blood gas measurements and pulmonary function tests. Patients were divided as those with or without neuropathy, and factors contributing to the development of neuropathy were investigated based on clinical and laboratory findings. Results. Eleven (24.4%) patients were women and 34 (74.6%) were men, and the mean age was 73.2 years. Mean PaO2 was 58.2 mmHg, pCO2 was 41.2 mmHg, and FEV1 was 45.3%. Neuropathy was diagnosed in twenty (44.4%) patients. Significant differences were found in pO2, pCO2, SO2, mMRC, smoking status and number of exacerbations per year (p < 0.05). Conclusions. Patients who experience frequent exacerbations and those with hypoxemia or hypercapnia as demonstrated should be taken into more careful clinical assessments with respect to polyneuropathy.