Childhood focal compressive mononeuropathies during the COVID-19 pandemic in Buenos Aires, Argentina.

INTRODUCTION/AIMS: Focal peripheral neuropathies are infrequently seen in pediatric patients. The COVID-19 pandemic has disrupted normal life for many people, including complete lockdowns and school closing for long periods of time in many countries, which prompted children to stay at home. Our aim is to assess whether there has been an increased incidence of focal compressive peripheral neuropathies in the pediatric population during COVID-19-associated lockdown. METHODS: Clinical, electrophysiological, and imaging characteristics were reviewed for patients referred to the electrodiagnostic (EDx) laboratory with suspicion of a focal neuropathy. The incidence of focal compressive peripheral neuropathies seen during the period of March to September 2020 was compared with the same time period in 2019. RESULTS: An increased incidence of focal neuropathies was seen in 2020 (31%) compared with 2019 (6.8%). During 2020, 7 fibular (peroneal) mononeuropathies and 2 ulnar neuropathies were diagnosed. Most patients with focal neuropathies were underweight and acknowledged prolonged screen time periods. Electrophysiological findings consisted of mostly demyelinating lesions with an overall good clinical outcome. DISCUSSION: In this study we raise awareness about a possible increased incidence of focal compressive peripheral neuropathies in children during COVID-19-associated lockdown, which may be prevented with changing positions during sedentary activities.

Multiple demyelinating sensory and motor mononeuropathy associated with COVID-19: a case report.

The involvement of the nervous system may occur in 36.4% of patients with COVID-19. Cases have been described of cerebrovascular diseases, encephalitis, encephalopathies, and changes in smell and taste. Two months after being discharged from hospital with COVID-19, a 63-year-old male patient presented with a predominantly demyelinating multiple sensory and motor mononeuropathy. A diagnostic possibility of multiple sensory and motor demyelinating mononeuropathy (Lewis-Sumner syndrome) was made. Treatment with human immunoglobulin was initiated. COVID-19 may be associated with multiple demyelinating sensory and motor mononeuropathy.

Estudos de condução nervosa no nervo tibial através do tunel do tarso em pacientes de hanseníase / Nerve conduction studies of the tibial nerveacross the tarsal tunnel in leprosy patients

Os autores avaliaram todos os exames de condução nervosa do nervo tibial dos pacientes com suspeita de neuropatia da hanseníase, aguda ou subaguda, atendidos no Ambulatório de Hansenologia do Instituto Lauro de Souza Lima (ILSL) no período de dois anos. Foram incluídos 75 pacientes, 52 masculinos e 23 femininos, com média de idade de 44,5 anos (21 a 73 anos), totalizando 150 nervos. Procurou-se caracterizar o comprometimento neurofisiológico individualizando-se os ramos plantar medial (PM) e plantar lateral (PL), observou-se que o mais envolvido foio PL com 57,4%, seguido do PM com 42,6%. O tipo de lesão nervosa mais frequente foi a de predomínio axonal, com 66%, seguida pela mielínica, com 28,7%.O envolvimento mais freqüente e desproporcional dor amo PL, além de evidenciar o caráter compressivo do comprometimento do tibial no túnel do tarso, remete a uma mononeuropatia múltipla compressiva nos membros inferiores. A alta prevalência do comprometimento do nervo tibial foi considerada uma marcada doença, da mesma forma que a neuropatia ulnar.

The authors assessed all tibial nerve conduction studies (NCS) of the patients under suspicious of acute or subacute leprosy neuropathy, who have been attended the Leprosy Ambulatory Clinic of the ILSL during a period of two years. Seventy-five patients have been included as follows: 52 male and 23 female, between 21 and 73 years old, with the mean age of 44.5 totaling 150 nerves The medial plantar (MP) and lateral plantar ( (LP) branches were studied separately. The most involved was the LP with 57.4%, followed bythe MP with 42.6%. The most frequent injury among the abnormal nerves was the axonal lesion with 66%, followed by the myelin lesion with 28.7%. The most frequent and disproportional involvement of thePL branch not only demonstrates the compressivecharacter of the tibial nerve injury in the tarsaltunnel but also indicates a multiple entrapment mononeuropathy in the lower limbs. The high prevalence of the tibial nerve injury was considered a hallmark of the disease, as well as the ulnar neuropathy.

Artrite reumatóide e mononeurite múltipla: relato de caso / Arthritis rheumatoids and mononeuritis multiplex: case report

A artrite reumatóide é uma doença inflamatória sistêmica crônica que se caracteriza por acometimento das articula­ções diartrodiais e, com frequência, outros órgãos. Entre as manifestações extra-articulares é importante destacar os acometimentos cardíaco, pulmonar, dermatológico e neurológico. A mononeurite múltipla é uma das manifes­tações neurológicas da artrite reumatóide e ocorre como consequência de uma vasculite reumatóide. O objetivo des­te estudo foi apresentar um caso de paciente com artrite reu­matóide com boa evolução após o tratamento

Confluent peripheral multiple mononeuropathy associated to acute hepatitis B: a case report.

A thirty three year-old, male patient was admitted at the Hospital of the São Paulo University School of Medicine, at the city of São Paulo, Brazil, with complaint of pains, tingling and decreased sensibility in the right hand for the last four months. This had progressed to the left hand, left foot and right foot, in addition to a difficulty of flexing and stretching in the left foot. Tests were positive for HBeAg, IgM anti-HBc and HBsAg, thus characterizing the condition of acute hepatitis B. The ALT serum level was 15 times above the upper normal limit. Blood glucose, cerebral spinal fluid, antinuclear antibodies (ANA) and anti-HIV and anti-HCV serum tests were either normal or negative. Electroneuromyography disclosed severe peripheral neuropathy with an axon prevalence and signs of denervation; nerve biopsy disclosed intense vasculitis. The diagnosis of multiple confluent mononeuropathy associated to acute hepatitis B was done. This association is not often reported in international literature and its probable cause is the direct action of the hepatitis B virus on the nerves or a vasculitis of the vasa nervorum brought about by deposits of immune complexes.