Although diabetic autonomic neurop athy involves most or-gans,diagnosis is largely based on c ardiovascular tests.Light reflex pupillography(LRP)non-invasively evaluates pupillary autonomic function.We te sted whether...Although diabetic autonomic neurop athy involves most or-gans,diagnosis is largely based on c ardiovascular tests.Light reflex pupillography(LRP)non-invasively evaluates pupillary autonomic function.We te sted whether LRP demonstrates autonomic pupillary d ysfunction in diabetics independently from cardiac autonom ic neuropathy(CAN)or peripheral neuropathy(PN).In 36type -II diabetics(39-84years)and 36controls(35-78years),we per-formed LRP.We determined diameter(PD),early and late redilation velocities(DV)as sympathetic parameters and reflex amplitude(RA)and constriction velocity(CV)as parasympathetic pupillary indic es.We assessed the frequency of CAN using heart rate variability tests and e-valuated the frequency of PN using neurological examina-tion,nerve conduction studies,thermal and vibratory threshold determination.Twenty-e ight (77.8%)patients had abnormal pupillography results,but only 20patients(56%)had signs of PN or CAN.In nine patient s with PN,only pupillography identified auto nomic neuropathy.Four patients had pupillary dysfunction but no CAN or PN.In comparison to controls,patients had reduced PD,late DV,RA and CV indicating sympathetic and parasympathetic dysfunction.The incidence and seve rity of pupillary ab-normalities did not differ between p atients with and without CAN or PN.LRP demonstrates sympathetic and parasym-pathetic pupillary dysfunction ind ependently from PN or CAN and thus refines the diagnosis of autonomic neuropa-thy in type -II diabetics.展开更多
To investigate the frequency of allergic disorders in myasthenia gravis (MG) p atients and characterize the features of MG associated with allergic disorders. Frequencies of past and present common allergic disorders ...To investigate the frequency of allergic disorders in myasthenia gravis (MG) p atients and characterize the features of MG associated with allergic disorders. Frequencies of past and present common allergic disorders in 160 MG patients who visited the Department of Neurology, Kyushu University Hospital from April 2000 to July 2003 and in 81 neurological normal controls were studied. Among various allergic disorders, the frequency of allergic conjunctivitis (AC) was significa ntly higher in MG patients (39/160, 24.4%, Pcorr=0.011 2), especially with MG w ithout thymoma (36/123, 29.3%, Pcorr=0.001 6), in comparison to the controls (6 /81, 7.4%). MG patients with AC showed a significantly higher rate of seronegat ive MG (43.6%vs. 17.4%, P=0.008) and a higher tendency of ocular MG (43.6%vs. 28.1%, P=0.071). Moreover, MG with AC had significantly lower anti acetylchol ine receptor antibody titers (median 6.8 nmol/L vs. median 23.6 nmol/l, P=0.035 9) as well as a lower rate of coexisting thymoma (7.7%vs. 17.4%, P=0.016). The incidence of myasthenic crisis was also lower in MG with AC than without AC, ye t the difference was not significant (7.7%vs. 15.7%). There was a significant association of AC with MG especially for ocular or seronegative MG in cases with out thymoma.展开更多
文摘Although diabetic autonomic neurop athy involves most or-gans,diagnosis is largely based on c ardiovascular tests.Light reflex pupillography(LRP)non-invasively evaluates pupillary autonomic function.We te sted whether LRP demonstrates autonomic pupillary d ysfunction in diabetics independently from cardiac autonom ic neuropathy(CAN)or peripheral neuropathy(PN).In 36type -II diabetics(39-84years)and 36controls(35-78years),we per-formed LRP.We determined diameter(PD),early and late redilation velocities(DV)as sympathetic parameters and reflex amplitude(RA)and constriction velocity(CV)as parasympathetic pupillary indic es.We assessed the frequency of CAN using heart rate variability tests and e-valuated the frequency of PN using neurological examina-tion,nerve conduction studies,thermal and vibratory threshold determination.Twenty-e ight (77.8%)patients had abnormal pupillography results,but only 20patients(56%)had signs of PN or CAN.In nine patient s with PN,only pupillography identified auto nomic neuropathy.Four patients had pupillary dysfunction but no CAN or PN.In comparison to controls,patients had reduced PD,late DV,RA and CV indicating sympathetic and parasympathetic dysfunction.The incidence and seve rity of pupillary ab-normalities did not differ between p atients with and without CAN or PN.LRP demonstrates sympathetic and parasym-pathetic pupillary dysfunction ind ependently from PN or CAN and thus refines the diagnosis of autonomic neuropa-thy in type -II diabetics.
文摘To investigate the frequency of allergic disorders in myasthenia gravis (MG) p atients and characterize the features of MG associated with allergic disorders. Frequencies of past and present common allergic disorders in 160 MG patients who visited the Department of Neurology, Kyushu University Hospital from April 2000 to July 2003 and in 81 neurological normal controls were studied. Among various allergic disorders, the frequency of allergic conjunctivitis (AC) was significa ntly higher in MG patients (39/160, 24.4%, Pcorr=0.011 2), especially with MG w ithout thymoma (36/123, 29.3%, Pcorr=0.001 6), in comparison to the controls (6 /81, 7.4%). MG patients with AC showed a significantly higher rate of seronegat ive MG (43.6%vs. 17.4%, P=0.008) and a higher tendency of ocular MG (43.6%vs. 28.1%, P=0.071). Moreover, MG with AC had significantly lower anti acetylchol ine receptor antibody titers (median 6.8 nmol/L vs. median 23.6 nmol/l, P=0.035 9) as well as a lower rate of coexisting thymoma (7.7%vs. 17.4%, P=0.016). The incidence of myasthenic crisis was also lower in MG with AC than without AC, ye t the difference was not significant (7.7%vs. 15.7%). There was a significant association of AC with MG especially for ocular or seronegative MG in cases with out thymoma.
