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A new approach in the relief of pain of leprous neuritis.

Transcutaneous Nerve Stimulation (TNS) has been known since the last several decades to relieve pain in many conditions. For the first time it was used in the treatment of the severe and agonizing pain caused by leprous neuritis with highly beneficial results without producing any side effects. This study was made on 40 patients, and in the majority of the cases there was total relief of pain with one application of a few hours duration. This encouraging result has led the authors to the conclusion that TNS could be a useful tool in a hospital where leprosy patients are treated.

Central Nervous System↗

Lupus optic neuritis with negative serology.

A 56-year-old woman with a 12-year history of systemic lupus erythematosus presented with severe optic-disc swelling and blepharitis. At the same time, she developed acute pancreatitis and ultimately died of gram-negative sepsis. Although it appeared that the ocular and systemic disorders were manifestations of lupus, her serum antinuclear antibody and complement levels remained normal throughout her hospital course. Optic neuritis may be secondary to lupus, but the diagnosis is difficult to make when the serology is negative.

Female↗

Evolution of visual evoked potentials in optic neuritis.

The visual evoked potential (VEP) latency was either abnormally prolonged or absent in the involved eye of 47 patients with optic neuritis. Twenty-two of these patients with known multiple sclerosis (MS), had similar abnormalities to 25 patients with no clinical evidence of MS. Follow-up clinical assessment and VEP were done 10 to 42 (mean 22) months later in 34 patients. In 15 of 34 patients with no VEP from the involved eye during initial examination, 6 returned to normal, 8 had prolonged latencies and 1 still had no response at follow up. Of 19 patients who initially had prolonged latencies in the involved eye, 6 returned to normal, 11 had prolonged latencies and 2 had no response at follow up. The VEP is helpful in confirming the diagnosis of ON. The examination must be performed when the patient is symptomatic or soon thereafter as 35% of our patients with an abnormal initial VEP had a normal VEP at follow up. This normalization was not related to the severity of the initial VEP abnormality.

Adult↗

Effect of corticosteroid on passively transferred experimental allergic neuritis.

Effect of prednisolone on experimental allergic neuritis (EAN) in Lewis rats was studied. In order to exclude the influence of residual antigens, we evaluated the effect in EAN passively transferred with living lymphoid cells. Prednisolone, when administered after the passive transfer, prevented EAN both clinically and histologically, but when administered after the clinical onset, it had little influence on the course of the disease. Prednisolone was suspected to have suppressed the sensitized cells, but to have had no remarkable effect after the clinical onset.

Animals↗

Extradural malignancy simulating brachial neuritis.

A 57 year old man is described who presented with symptoms and signs suggestive of brachial neuritis. Sparing of the serratus anterior both clinically and on electromyography suggested that the lesion was in the brachial plexus, thus supporting the diagnosis. Subsequent investigation showed an extradural tumour at C5-C6 level. Sparing of serratus anterior does not definitively localize the pathology as distal to the nerve roots.

Adenocarcinoma↗

Prognostic value of cerebrospinal fluid electrophoresis in optic neuritis and suspected multiple sclerosis.

The prognostic significance of cerebrospinal fluid electrophoresis and IgG-index has been investigated in 44 patients, of whom 10 had optic neuritis and 34 suspected, possible or probable multiple sclerosis. The predictive value of CSF oligoclonal banding for future disease dissemination is very high in the suspected multiple sclerosis subgroup, where after a follow-up of 4.4 years, 7 out of 7 band-positive patients displayed further disease activity. The absence of CSF oligoclonal bands seems to carry a relatively benign short-term (follow-up 3.4 years) prognosis in suspected MS cases.

Adult↗

[Features of the course of retrobulbar neuritis in alcoholic intoxication].

The authors analyzed the course of bilateral retrobulbar neuritis (RN) in 39 patients with alcoholic intoxication. In almost one-third of those studied RN was first the only sign of the disease (24 patients suffered from chronic alcoholism of different stages). They were followed up for 1 to 3 years. Characteristics of disorders of the central and peripheral vision and of the status of the ocular fundus were found to correlate with general signs of intoxication. The data obtained my be of a definite significance for the timely specification of the diagnosis and aetiology of the process in patients with syndromes of bilateral RN.

Adult↗

Malignant external otitis with optic neuritis.

Malignant external otitis (MEO) is a progressive necrotizing infection which spreads to the skull base. The causative organism is usually Pseudomonas aeruginosa and 90% of the patients are diabetic. The infection gains access to the skull base at the temporal bone. Cranial nerve involvement is common. We present a case of malignant external otitis causing blindness due to optic neuritis. Progressive vascular involvement along the skull base is the pathogenic mechanism that best explains spread from the temporal bone to the orbital apex.

Aged↗

[Integrative index of the results of functional studies in patients with neuritis of the radial nerve during rehabilitation].

The authors propose a principle of a comprehensive approach to the assessment of neuromuscular and hemodynamic disorders in patients with radial neuritis of nontraumatic genesis. It has been established that the integrative parameter of the results of functional studies makes it possible to predict the outcome of the disease and to objectively evaluate the severity of the disease and the adequacy of the rehabilitation treatment.

Electromyography↗

Neurosyphilis and retrobulbar neuritis in a patient with AIDS.

A 33-year-old homosexual patient with acquired immune deficiency syndrome (AIDS) developed sudden unilateral loss of vision. Slit-lamp and funduscopic examination of the affected eye was completely within normal limits. The patient, however, had a Marcus Gunn pupil, decreased color vision, and a large central scotoma on visual field examination. This was consistent with retrobulbar optic neuritis. Laboratory investigation revealed a highly positive serum and cerebrospinal fluid venereal disease reaction level (VDRL). A diagnosis of neurosyphilis was made, and the patient was treated with ten days of intravenous penicillin therapy. Ophthalmologists should be aware that many patients with AIDS have also been exposed to syphilis. Regardless of their clinical presentation, all AIDS patients should be examined and tested for syphilis and treated as is necessary.

Acquired Immunodeficiency Syndrome↗

[Retrobulbar optic neuritis as an initial symptom of multiple sclerosis. Results of a prospective study].

40 patients with idiopathic optic neuritis (ON) between 1st January 1967 and 31st December 1977 have been checked again from oculistic and neurological point of view between 1st January and 31st March 1983. 10 of 40 examined patients (25%) are found suffering from multiple sclerosis (MS) at the time of check up. Our research points out that idiopathic ON evolutive risk towards MS is greater in females, in people between 20 and 40 years old, in people with one or more relapses as well as in people with neurological microsymptoms at the time of ON.

Adolescent↗

[Pseudo-optic neuritis as a manifestation of craniopharyngioma (2 cases)].

In two case of cystic craniopharyngioma the initial presentation was misleading and suggested acute retrobulbar optic neuritis: 1) isolated and unilateral drop of visual acuity of recent onset; 2) total remission in a few weeks, then a relapsing and steroid-sensitive course; 3) increase of C.S.F. gammaglobulins content in one case, normal CT scan in the second one. The diagnosis was corrected 36 and 18 months respectively after the onset of the clinical disorders.

Adult↗

Experimental allergic neuritis. Ultrastructure of serum-induced myelin aberrations in peripheral nervous system cultures.

Mature myelinated cultures of mouse dorsal root ganglia (sometimes grown in combination with spinal cord tissue) have been exposed to unheated and heated (complement-inactivated) serum from rabbits with experimental allergic neuritis (EAN). Experimental cultures were examined for periods ranging from several hours to approximately 2 weeks of exposure. Some cultures were exposed to EAN serum for approximately 1 week then returned to normal medium for examination of the reversibility of the lesions. Unheated EAN serum induced demyelination of peripheral nervous system fibers within 96 hours of exposure. Following removal of the EAN serum, affected fibers remyelinated. Heated EAN serum produced a type of myelin swelling identical with that described previously in spinal cord explants exposed to serum from rabbits with experimental allergic encephalomyelitis. The lamellar spacing of the peripheral nervous system meylin was increased to approximately 23 nm. and the normal bifilar intraperiod line was increased to four leaflets. Some hypermyelination was seen. The swelling was incompletely reversible following removal of the heated serum. These findings are discussed in terms of their relevance to immunemediated demyelination and peripheral neuropathy associated with the hypergammaglobulinemic states.

Animals↗

[Facial neuritis in middle-aged and elderly patients].

The progress of facial nerve neuritis was studied clinically in 59 patients of middle and old age with atherosclerosis and arterial hypertension. The patients were divided into 3 groups. An inflammatory genesis of prosoplegia was established in the first group (12 cases). The second group (24 cases) showed symptoms of the inflammatory process with a predominance of vascular insufficiency. This circumstance hampered elucidation of the etiology of the disease, but pointed to crucial significance of vascular factors in the development of prosoplegia. The third group (23 cases) demonstrated a vascular nature of prosoplegia. It is assumed that the importance of insufficiency in the blood supply of the facial nerve in the etiopathogenesis of prosoplegia in most patients should be reflected in the approach to its treatment.

Adult↗

[Role of functional interaction between the facial and masticatory muscles in the genesis of synkineses in patients with neuritis of the facial nerve].

The electromyogram of orbicular muscles of the eye and masticatory muscles was studied in 19 patients with facial nerve neuritis and 11 normals. In a maximum contraction of the masticatory muscles, the orbicular muscles of the eye showed an activity equal to about 9% of the maximum amplitude of the orbicular muscles. Similar activity in the paretic muscles was not decreased. The development of secondary synkinesia is postulated.

Adolescent↗

[Favorable effect of procaine administration in retrobulbar optic neuritis].

The author reports 12 cases of retrobulbar neuritis of recent onset in which intravenous procaine exerted unexpectedly an immediate favourable effect. The treatment consisted of intravenous drip infusion of 40 ml of 1% procaine in 400 ml of 5% glucose during 7 days. The author supposes that the therapeutic effect was due to the antiallgeric action of procaine (blocking of histaminergic receptors) and its spasmolytic influence.

Adolescent↗