Asunto(s)
Enfermedades del Sistema Nervioso Periférico/epidemiología , Enfermedades del Sistema Nervioso Periférico/etiología , Polineuropatías/epidemiología , Polineuropatías/etiología , Adolescente , Adulto , Distribución por Edad , Anciano , Anciano de 80 o más Años , Esclerosis Amiotrófica Lateral/diagnóstico , Esclerosis Amiotrófica Lateral/epidemiología , Esclerosis Amiotrófica Lateral/fisiopatología , Biopsia , Niño , Citocinas/sangre , Citocinas/líquido cefalorraquídeo , Diagnóstico Diferencial , Femenino , Humanos , Japón/epidemiología , Masculino , Persona de Mediana Edad , Enfermedades del Sistema Nervioso Periférico/diagnóstico , Enfermedades del Sistema Nervioso Periférico/fisiopatología , Polineuropatías/diagnóstico , Polineuropatías/fisiopatología , Adulto JovenRESUMEN
BACKGROUND: Multifocal motor neuropathy (MMN) is characterized by clinical improvement with intravenous immunoglobulin and the frequent detection of anti-ganglioside antibodies. However, the immunological background of the neuronal damage in MMN is still unclear. OBJECTIVE: The aim of this study is to investigate abnormalities in the cytokine and chemokine profiles of MMN patients. METHODS: Sera from 16 patients with MMN, 16 patients with sporadic amyotrophic lateral sclerosis (ALS), and 15 patients with other non-inflammatory neurological diseases (ONDs) were analyzed for 27 cytokines and chemokines using a multiplex bead array. We also checked whether the altered cytokine/chemokine profile in the MMN group differed significantly in the presence or absence of abnormal electrophysiological findings. RESULTS: Serum IL-1Ra, IL-2, G-CSF, TNF-α, and TNFR1 levels were significantly higher in the MMN group than in the ONDs group. Of these, G-CSF and TNF-α also showed significant increases compared to the ALS group. Serum G-CSF and TNF-α levels were significantly higher in MMN patients presenting with focal demyelination including conduction block than in patients without any focal demyelination. CONCLUSIONS: Proinflammatory cytokines may contribute to peripheral nerve demyelination in MMN.
Asunto(s)
Esclerosis Amiotrófica Lateral/sangre , Citocinas/sangre , Trastornos del Movimiento/sangre , Polineuropatías/sangre , Adulto , Anciano , Anticuerpos/sangre , Estudios de Casos y Controles , Electromiografía , Ensayo de Inmunoadsorción Enzimática , Potenciales Evocados Motores/fisiología , Femenino , Gangliósidos/inmunología , Humanos , Masculino , Persona de Mediana Edad , Trastornos del Movimiento/complicaciones , Polineuropatías/complicaciones , Estudios RetrospectivosRESUMEN
We report a patient with cerebral air embolism in whom we could perform serial brain magnetic resonance images (MRIs). A 78-year-old man was admitted to our hospital because of recurrent empyema after surgery for esophageal cancer. He suddenly demonstrated left hemiparesis in the middle of pleural lavage. After about 30 minutes from onset, the computed tomography (CT) revealed multiple air-isodense spots in the right hemisphere of the brain. After about 2 hours from onset, many hypointense spots in the right hemisphere were revealed on T2*-weighted image (T2*WI). These findings suggested cerebral air embolism. He didn't receive hyperbaric oxygen therapy because he had status epilepticus. The hypointense spots on the T2*WI became smaller and spread after 7 hours from onset and almost disappeared after 53 days. It is important to recognize that cerebral arterial air embolism is similar to multiple microbleeds and cerebral arteriovenous fistula in hypointense spots on the T2*WI.