We report a case of chronic acquired neuropathy predominantly affecting senso ry and autonomic nerves. Investigations showed a demyelinating polyradiculoneuro pathy with axonal degeneration and depletion of postgangli...We report a case of chronic acquired neuropathy predominantly affecting senso ry and autonomic nerves. Investigations showed a demyelinating polyradiculoneuro pathy with axonal degeneration and depletion of postganglionic noradrenergic fib ers in the rectal mucosa. Intravenous immunoglobulin and corticosteroid administ ration were effective in alleviating symptoms and improving electrophysiological abnormalities. This neuropathy may be a novel variant of chronic inflammatory d emyelinating polyradiculoneuropathy (CIDP), in which autoimmunoreactivity is directed not only against myelin but also against axon-or ganglion-compos ing protein. Autonomic nerve involvement does not exclude a diagnosis of CIDP.展开更多
Objective: Inadequate supraspinal modulation of spinal motor control mechanism s such as α-γcoactivation is supposed to cause difficulty in maintaining prop er voluntary contraction in Parkinson’s disease (PD). Met...Objective: Inadequate supraspinal modulation of spinal motor control mechanism s such as α-γcoactivation is supposed to cause difficulty in maintaining prop er voluntary contraction in Parkinson’s disease (PD). Methods: Subjects were 42 patients with PD and 20 normal volunteers. Soleus H-reflex and tendon tap refl ex (T-reflex) were recorded. The maximal reflexes (Hmax and Tmax) at rest were recorded first. Next, the stimulus intensities were fixed to obtain a reflex siz e of around 25%of Mmax at rest for both H-and T-reflexes, and the reflexes we re recorded at rest, during tonic plantarflexion (TPF), and at the onset of plan tarflexion. Results: Hmax at rest was 55%and Tmax 30%in normal subjects, while they were 36 and 31%, respectively,in PD. The size ratio of Tmax and Hmax at r est in PD was larger than normal. In PD, the size of H-reflex increased with TP F as in normal subjects, but T-reflex decreased. These changes in T-reflex wer e correlated with the grade of rigidity, bradykinesia,and time for 10 m gait. H -reflex had no such correlations.Conclusions: T-reflex was abnormally modulate d in PD especially during tonic contraction. Significance: Inappropriate suprasp inal modulation of the spinal reflex pathways disturbs motor performance in PD.展开更多
文摘We report a case of chronic acquired neuropathy predominantly affecting senso ry and autonomic nerves. Investigations showed a demyelinating polyradiculoneuro pathy with axonal degeneration and depletion of postganglionic noradrenergic fib ers in the rectal mucosa. Intravenous immunoglobulin and corticosteroid administ ration were effective in alleviating symptoms and improving electrophysiological abnormalities. This neuropathy may be a novel variant of chronic inflammatory d emyelinating polyradiculoneuropathy (CIDP), in which autoimmunoreactivity is directed not only against myelin but also against axon-or ganglion-compos ing protein. Autonomic nerve involvement does not exclude a diagnosis of CIDP.
文摘Objective: Inadequate supraspinal modulation of spinal motor control mechanism s such as α-γcoactivation is supposed to cause difficulty in maintaining prop er voluntary contraction in Parkinson’s disease (PD). Methods: Subjects were 42 patients with PD and 20 normal volunteers. Soleus H-reflex and tendon tap refl ex (T-reflex) were recorded. The maximal reflexes (Hmax and Tmax) at rest were recorded first. Next, the stimulus intensities were fixed to obtain a reflex siz e of around 25%of Mmax at rest for both H-and T-reflexes, and the reflexes we re recorded at rest, during tonic plantarflexion (TPF), and at the onset of plan tarflexion. Results: Hmax at rest was 55%and Tmax 30%in normal subjects, while they were 36 and 31%, respectively,in PD. The size ratio of Tmax and Hmax at r est in PD was larger than normal. In PD, the size of H-reflex increased with TP F as in normal subjects, but T-reflex decreased. These changes in T-reflex wer e correlated with the grade of rigidity, bradykinesia,and time for 10 m gait. H -reflex had no such correlations.Conclusions: T-reflex was abnormally modulate d in PD especially during tonic contraction. Significance: Inappropriate suprasp inal modulation of the spinal reflex pathways disturbs motor performance in PD.
