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PubMed1992

Focal conduction block in the dorsal root ganglion in experimental allergic neuritis.

Acute experimental allergic neuritis was induced in Lewis rats by inoculation with bovine intradural root myelin and adjuvants. In terminal experiments, sensory conduction was assessed in rats with hindlimb ataxia and weakness by stimulating the exposed sciatic nerve and recording directly from the exposed L-4 spinal nerve, dorsal root ganglion, dorsal root, and dorsal root entry zone. Focal conduction block was present in a high proportion of large-diameter fibers in the dorsal root ganglion. In contrast, nerve conduction in the peripheral nerve and spinal nerve was essentially normal apart from probable conduction block in some fibers in the proximal spinal nerve in a minority of rats. The afferent volley arriving at the dorsal root entry zone of the spinal cord was greatly reduced, as a consequence of the conduction block in the dorsal root ganglion and probable conduction block in the dorsal root. The M wave recorded from the fourth dorsal interosseus muscle of the hindfoot was normal in amplitude but slightly prolonged in latency and the H reflex was absent. These electrophysiological findings correlated well with the histological findings of inflammation and prominent demyelination in the dorsal root ganglia and dorsal roots with minimal involvement of the proximal spinal nerve and no involvement of the sciatic nerve. It is concluded that the hindlimb ataxia in rats with this form of acute experimental allergic neuritis is due to demyelination-induced nerve conduction block in the dorsal root ganglia and probably in the dorsal roots.

Afferent Pathways↗

PubMed1992

Shared T-cell receptor gene usage in experimental allergic neuritis and encephalomyelitis.

Experimental allergic neuritis, an autoimmune disease of the peripheral nervous system, is a model for human Guillain-Barré syndrome. Experimental allergic neuritis is mediated by CD4+ T cells reactive with myelin P2 protein. We demonstrate that these T cells use the same members of T-cell receptor V gene families for both their alpha (V alpha 2) and beta (V beta 8) chains as T cells that cause experimental allergic encephalomyelitis, an autoimmune disease of the central nervous system. Furthermore, these T cells appear to be idiotypically related. Therefore, completely different T-cell lines with different antigen specificities, producing entirely different diseases, share common T-cell receptors.

Amino Acid Sequence↗

PubMed1998

Expression of integrins in experimental autoimmune neuritis and Guillain-Barré syndrome.

Integrins are a subclass of adhesion molecules that mediate cell-cell and cell-extracellular matrix interactions. Integrins influence transendothelial migration of lymphocytes and monocytes and are suitable targets for experimental immunotherapy. They are critically involved in the pathogenesis of autoimmune neuritis and abnormally expressed in human neuropathies. Also, the role of integrins in myelination, neurite outgrowth, and nerve regeneration suggests that they could be involved in the recovery phase of immune-mediated neuropathies. We investigated by immunohistochemistry the expression of a number of integrin subunits during the course of experimental autoimmune neuritis (EAN). Results were compared with the human immune neuropathy Guillain-Barre syndrome (GBS) and extended in vitro. Inflammation and demyelination in both EAN and GBS induced the down-regulation of beta4 integrin in Schwann cells (SCs), whereas loss of alpha2 was noted only in EAN. When axonal loss was present, SCs displayed alpha5 integrin, in both EAN and GBS. In vitro, basal lamina and inflammatory cytokines modulated the expression of beta4 in SCs, but they did not influence alpha2 and alpha5 expression. Finally, integrins were differentially expressed in blood vessels during EAN. In conclusion, the spatiotemporal changes in integrin expression may be used to characterize, stage, and better understand the pathogenesis and evolution of inflammation during GBS and EAN. This may help to establish useful, novel therapy for immune-mediated neuropathies.

Animals↗

PubMed2003

Neurophysiological changes in demyelinating and axonal forms of acute experimental autoimmune neuritis in the Lewis rat.

Myelin-sensitized T- and B-cells (lymph node cells) induced experimental autoimmune neuritis (EAN) in Lewis rats after passive transfer to naive recipients. After 6 days, all recipient rats developed tail paresis that progressed to limb paresis within 12-72 h. Progressive nerve conduction changes consistent with demyelination in the sciatic nerve (conduction block and prolongation of the distal motor latencies) and lumbar nerve roots (initial low F-wave frequencies followed by later prolongation in F-wave latencies) were observed during the disease. For comparison, adoptive transfer experimental autoimmune neuritis (AT-EAN) of differing disease severity was induced by titrating the dose of P2-specific T-cells. In contrast to EAN induced by myelin-sensitized T- and B-cells, AT-EAN was predominantly associated with rapid nerve conduction changes consistent with axonal dysfunction and degeneration. These findings demonstrate that distinct forms of EAN with different pathophysiological mechanisms are induced by the passive transfer of P2-specific T-cell lines or myelin-specific T-cells and B-cells. The electrophysiological changes in EAN induced by myelin-specific T- and B-cells are very similar to those seen clinically during acute inflammatory demyelinating polyneuropathy, whereas AT-EAN has less resemblance to axonal forms of Guillain-Barré syndrome.

Action Potentials↗

PubMed1987

T-lymphocyte subsets, functional deficits, and morphology in sciatic nerves during experimental allergic neuritis.

Conduction velocities, demyelination, "macrophage/dendritic" cells, different sets of T-lymphocytes, and immunoglobulins were estimated in sciatic nerves during various phases of experimental allergic neuritis in Lewis rats. Demyelination was minimal day 15 postimmunization (p.i.) when conduction velocity already was reduced, somewhat more pronounced day 17 p.i. when nerve conduction was blocked, and most pronounced day 23 p.i. when nerve conduction partially had recovered. This suggests a dissociation between the degree of demyelination and the functional deficits. Decrease of sciatic nerve conduction velocities coincided with endoneurial appearance of T-lymphocytes and "macrophage/dendritic" cells, as well as endoneurial immunoglobulins, day 15 p.i. Later partial functional recovery occurred in parallel with the disappearance of T-cells. The degree of functional deficits thus correlated with the number of endoneurial T-lymphocytes. T-cells may, directly or indirectly, initiate several of the disease components in experimental allergic neuritis, including the nerve conduction deficit.

Animals↗

PubMed1988

Comparison of automated perimetry and pattern visually evoked cortical potentials in optic neuritis.

Twenty-one eyes of thirteen patients suffering from optic neuritis were examined with the Octopus automated perimeter and pattern visually evoked cortical potentials. All eyes had visual acuity of 0.2 or better. Visual field examination was measured by program 31 or 33, which tests the central 30-degree fields in a 6-degree grid. Pattern evoked potentials were obtained by reverse checkerboard stimulation of 3 rev/sec. A prolonged P100 latency was related to at least one abnormal point in the central nine points of program 31. All seven eyes with one abnormal point in the center had a delayed peak latency. The patients with either the normal central nine points of program 31 or normal peak latency had visual acuity of 0.6 or better. The graphs of visual acuity by Octopus compared with pattern evoked potential were very similar. With program Delta, the sensitivity loss ratio, i.e., the ratio of the mean loss at eccentricity of less than 10 degrees over less than 30 degrees, was related to the peak latency in optic neuritis caused by multiple sclerosis.

Adolescent↗

PubMed1989

Electrophysiology and perimetry in acute retrobulbar neuritis.

Eighteen patients with acute retrobulbar neuritis were examined by visual field analysis and electroophthalmological recordings. The visual fields were measured to 30 degrees with the automatic perimeter Octopus 201. The pattern-evoked cortical potential showed an increased P-100 latency followed by a decrease in 12 patients during the first two weeks of the disease. This latency change cannot be explained by remyelinization. Teh positive component of the pattern ERG (P-50) was reduced in all acutely affected eyes in comparison with the fellow eye. During recovery, the amplitude of the positive PERG component increased to normal, but remained slightly reduced in comparison with the response from the fellow eyes. Thirteen patients out of 18 were clinically and electrophysiologically diagnosed as having unilateral retrobulbar neuritis. However, static perimetry showed paracentral scotomas in the fellow eye in 5 cases. Recovery of the severely affected eye was accompanied by complete normalization of the visual field in the fellow eye. Thus static perimetry seems to be a more sensitive test than even the visual evoked potentials for detecting lesions in the visual pathway.

Adult↗

PubMed1979

Erythrocyte unsaturated fatty acid test (E-UFA test): a biological test to detect optic neuritis as initial feature of multiple sclerosis.

Retrobulbar optic neuritis, though suspicious is not always considered as a possible onset of MS. For this reason we submitted to the E-UFA (erythrocyte unsaturated fatty acid) test, 41 subjects who suffered from one or several episodes of retrobulbar optic neuritis with no other neurological signs. The test was positive in 14 subjects (34, 1%).

Adolescent↗

PubMed1982

Multimodality evoked potentials and electrically elicited blink reflex in optic neuritis.

Pattern shift visual evoked potentials, brain stem auditory evoked potentials, spinal and scalp recorded somatosensory evoked potentials, and electrically elicited blink reflexes were investigated in 32 patients with isolated optic neuritis. Eleven patients were shown to have one additional lesion in the central nervous system outside the optic nerve. Therefore, cases with optic neuritis of unknown origin should be considered as possible cases of multiple sclerosis.

Adolescent↗

PubMed1984

Brachial neuritis in salmonellosis.

A case of bilateral brachial plexus neuritis associated with a salmonella infection is reported. The three types of nerve involvement in salmonellosis, mononeuritis, brachial plexus neuritis and polyradiculoneuritis are described. Prognosis and pathogenesis are discussed.

Adolescent↗

PubMed1987

Major histocompatibility antigens and lymphocyte subsets during experimental allergic neuritis in the Lewis rat.

Major histocompatibility antigens were identified in frozen sections of normal Lewis rat peripheral nerve tissue with monoclonal antibodies and an avidin-biotin-peroxidase complex system. Class I antigen is normally required for cytotoxic/suppressor T lymphocyte function and class II antigen for activation of helper T lymphocytes. In the sciatic nerves class I antigen was expressed diffusely by most endoneurial and perineurial cells but class II antigen only by a minority. In the cauda equina class I antigen was expressed by all arachnoid and some endoneurial cells, while class II antigen was expressed by a smaller proportion of arachnoid cells in the endoneurium of spinal roots and interstitial cells surrounding dorsal root ganglion neurons. The endothelium of endoneurial, perineurial and meningeal vessels uniformly expressed class I but not class II antigen. Experimental allergic neuritis was induced in Lewis rats by immunisation with bovine intradural root myelin. Early lesions consisted of multifocal infiltration of the nerve roots by cells expressing leucocyte common antigen. Surrounding endoneurial cells showed markedly increased expression of major histocompatibility antigens. In inflammatory lesions about 10% of the cells were stained with pan T cell antibodies. T lymphocyte subsets were identified with antibody W3/25 for helper cells and MRC OX-8 for cytotoxic/suppressor cells. The W3/25 positive cells were usually slightly in excess of OX-8 positive cells and their relative proportions did not alter during the disease. The presence of class I antigen on normal endothelium and its increased expression on endoneurial cells in the early phase of inflammation suggest an important role for class I restricted lymphocytes in the pathogenesis of the early stages of experimental allergic neuritis.

Animals↗

PubMed1975

The pattern evoked responses (VER) in optic neuritis.

Five patients presenting clinically accepted signs of optic neuritis served as subjects for a study on EP's (evoked potentials); the patients were tested during the acute phase, the chronic phase and at a stage when no impairment was clinically observed. At the acute phase of optic neuritis the VER was massively altered; in the chronic phase delayed latencies depending upon the impairment of visual acuity and visual fields could be recorded. At the recovery stage, while visual acuity and visual field showed no deficit, not only delayed latencies but also reduction in the amplitude at all stimulation frequencies were recorded.

Evoked Potentials↗

PubMed1996

Long echo time STIR sequence MRI of optic nerves in optic neuritis.

MRI of the optic nerves was obtained in 13 patients with acute optic neuritis and 13 with a previous optic neuritis (ON), assessed by clinical features, visual fields and visual evoked potentials. Results of the conventional short tau inversion recovery (STIR) sequence obtained with a short echo time (STE-STIR; 22 ms) were compared with those of a long echo time (LTE-STIR: 80 ms) sequence. The conventional STE-STIR sequence revealed lesions in the optic nerves in 78.5% of acute and 58.8% of previous ON. The LTE-STIR sequence showed abnormalities in 92.8% of acutely symptomatic nerves and 94.1% of nerves with previous ON. The optic nerve lesions appeared significantly longer with the LTE-STIR sequence than with the conventional STE-STIR sequences, in both acute and previous ON.

Adult↗

PubMed1993

Comparison between the flicker test procedures of Aulhorn and of Dölle in the diagnosis of optic neuritis.

The use of the flicker test for diagnostic purposes is based on the absence of Brücke's effect during acute inflammation of the optic nerve. The test device of Aulhorn was compared with another, less expensive flicker test device, that of Dölle. The flicker test device of Aulhorn uses a mechanical projection system. In the device of Dölle, the flicker field is formed by electronically controlled groups of light-emitting diodes. In an initial examination, the reliability of Aulhorn's test was slightly higher than of Dölle's procedure. The normal ranges in 45 healthy subjects differed markedly between the two methods. One hundred and fifteen eyes of patients with established or suspected optic neuritis were also examined. Although there were differences in some conditions (e.g. shape and homogeneity of flicker field) due to the techniques, the specificity and sensitivity of the two methods were similar concerning the diagnosis of acute optic neuritis.

Acute Disease↗

PubMed1994

Bilateral optic neuritis with branch retinal artery occlusion associated with vaccination.

A case of a 40-year old marine with bilateral optic neuritis and a branch retinal artery occlusion after vaccination is presented. Blood investigations showed no abnormalities. Cerebrospinal fluid studies revealed a lymphocytic pleocytosis and IgG antibodies against hepatitis A and rabies. Computerized tomography and magnetic resonance imaging of the brain were negative. A diagnosis of vaccine-induced auto-immune demyelinative optic neuritis was made. The clinical picture improved after systemic corticosteroid treatment.

Adult↗

PubMed1985

Acute bilateral brachial plexus neuritis associated with hypersensitivity vasculitis. A case report and review of literature.

The occurrence of brachial plexus neuritis during the acute phase of vasculitis is uncommon. We describe a patient with a long history of rhinitis and a recent onset of asthma, who developed purpuric skin lesions, abdominal pain, eosinophilia and brachial neuritis along with evidence of sacral plexus neuropathy. High dose steroids and cyclophosphamide induced a remission. He stopped all medications after 3 years and after 6 years the patient has some fixed minimal residual neurological deficit. The importance of aggressive therapy in treating extensive polyneuropathy during the acute phase of hypersensitivity vasculitis is raised. A possible cytotoxic role of eosinophils in the pathological process is suggested.

Acute Disease↗

PubMed1980

A simple psychophysical technique provides early diagnosis in optic neuritis.

Patients with optic neuritis describe image fading which is particularly evident at bright light levels. The effect is dependent on adaptation level, and high adaptation levels serve as a provocative test. Kinetic and static perimetry and interferometric acuity tests repeated in time reveal this loss in sensitivity. The latter test, using a large field and a high luminance level, is particularly sensitive to both the residua of pathology and very early phases of disease, often before subjective manifestations of anomalies are present. These effects are large in patients with demyelinating diseases. Here, we show that such changes may be revealed in optic neuritis due to other causes as well. Note, the same form of response may be detected in more central lesions, but usually in more circumscribed areas of field.

Adult↗

PubMed1991

Magnetic resonance imaging in a case of mumps postinfectious encephalitis with asymptomatic optic neuritis.

A 5-year-old male patient with asymptomatic optic neuritis and mumps postinfectious encephalitis or acute disseminated encephalomyelitis is reported. Magnetic resonance imaging (MRI) with a short inversion time inversion recovery sequence was valuable in detecting clinically silent lesions of the unilateral right optic nerve in addition to visual evoked potentials. Evidence of concurrent optic neuritis was useful for detecting more extensive neurological involvement, leading to the diagnosis of mumps postinfectious encephalitis. A systematic MRI study should be performed in children with mumps encephalitis, regardless of appreciable clinical deficits.

Child, Preschool↗