Peripheral neuropathy in Parkinson's disease.

BACKGROUND: Recent studies suggest an increased frequency of peripheral neuropathy (PN) in Parkinson's disease patients (PD) (Toth et al. 2010). The aim of our study is to verify the increased frequency of PN in our group of PD patients compared to an age-matched control group. We sorted patients according to the duration of L-DOPA treatment, L-DOPA dosage, and age below or over 50 years. METHODS AND RESULTS: We conducted electromyography examinations (using conduction studies and needle electromyography) of 49 PD patients with asymptomatic polyneuropathy and 40 controls. Patients without risk factors for PN were included (fasting blood was analyzed to rule out possible causes of PN), as were relatively healthy controls without risk factors for PN. PN was defined using the American Academy of Neurology and Electrodiagnostic Medicine criteria (England et al. 2005). CONCLUSION: The frequency of polyneuropathy was significantly higher in PD patients than in controls (45% versus 2%, p<0.0001). We did not establish a relationship in the PD group according to long-term L-DOPA usage, PD duration, or age. It should be assumed that a neurodegenerative process underlies the involvement of the central and peripheral nervous systems in PD patients.

Peripheral nerve involvement and severity of motor disorder in Parkinson's disease: a correlational study.

BACKGROUND: The aim of this study was to test the hypothesis that there is concomitant peripheral nerve involvement in patients suffering from neurodegenerative disorders by correlating motor and peripheral nerve involvement in Parkinson's disease. METHODS AND RESULTS: A total of 23 patients suffering from Parkinson's disease diagnosed strictly according to the UKPDBB criteria were examined. The group comprised 14 males (mean age: 57 years, mean age at onset: 51 years, mean duration of disease: 7 years, mean duration of dopaminergic treatment: 4 years) and 9 females (mean age: 67 years, mean age at onset: 63 years, mean duration of disease: 4 years, mean duration of dopaminergic treatment: 1 year). CONCLUSION: Polyneuropathy was clinically present and confirmed using EMG examination in 10 patients (43.5 %), 5 males and 5 females. This suggests that the neurodegenerative process involves both the central and the peripheral nervous system in Parkinson's patients.

[Development of carpal tunnel syndrome after being certified and an occupational disease]. / Rozwój zespolu ciesni nadgarstka (ZCN) po stwierdzeniu choroby zawodowej.

The authors present the results of the study carried out in South Moravia, Czech Republic, in a group of 140 patients (76 women and 64 men) with occupational carpal tunnel syndrome (CTS). The time-lag between the occupational disease certification and the investigation ranged from 2 to 14 years. The mean age of persons at the diagnosis was 44.5 +/- 7.4. years, and the duration of hazardous occupational exposure was 19.8 +/- 9.8 years. Repetitive and excessive strain of upper extremities was observed in 59% of patients and locally transmitted vibrations to the hands or vibration combined with repetitive and excessive strain of upper extremities in 41% of patients. Following the CTS certification as an occupational diseases, 98% of patients were removed from exposure to etiologic factors. During a follow-up examination, 19% of patients evaluated their health condition as better or recovered, deterioration was reported by 28%, and unchanged condition by 63% of subjects. Surgery was performed on 61% of patients. The comparison of the examination outcome at CTS certification as an occupational disease with the follow-up examination indicated significant improvement of distal motor latency, but the complete recovery of the median nerve conduction was found only in 13% of patients.