Functional recovery of untreated human immunodeficiency virus-associated Guillain-Barré syndrome: a case report.

HIV-associated Guillain-Barré syndrome is a well-documented phenomenon, typically occurring at seroconversion. GBS may result in functional impairment treated with a combination of medications, plasmapheresis, and rehabilitation. The quantified functional recovery of HIV-associated GBS with or without HIV treatment is not well described. Utilizing serial FIM scoring, we describe a patient's recovery from HIV-associated GBS after treatment with IVIg and acute inpatient rehabilitation without HIV treatment.

Anti-MAG/SGPG associated neuropathy does not commonly cause distal nerve temporal dispersion.

Patients with anti-myelin associated glycoprotein (anti-MAG) neuropathy have uniform slowing without temporal dispersion, but do usually have disproportionately distal slowing. We evaluated distal compound muscle action potential (CMAP) dispersion in 29 patients with anti-MAG/sulphated glucuronyl paragloboside (SGPG) neuropathy (titres > or = 12,800). Among 138 motor responses, 15% (tibial), 7.3% (peroneal), 10.7% (median) and 13.8% (ulnar) had distal CMAP duration > 9 ms. Disproportionate distal slowing with normal distal CMAP duration in the arms may be useful to differentiate chronic inflammatory demyelinating polyneuropathy from anti-MAG/SGPG associated neuropathy.

Characteristics of patients with sensory neuropathy diagnosed with abnormal small nerve fibres on skin biopsy.

Clinical, laboratory and electrodiagnostic (EDX) characteristics of 62 patients with sensory neuropathy with abnormal skin biopsies were reviewed. Reduced epidermal nerve fibre density (ENFD) was seen in 71% and morphological changes with normal ENFD were seen in 29% of the patients. Patients with small fibre sensory neuropathy may have associated large fibre loss undetected by routine EDX. Identified associations included abnormal glucose metabolism, Lyme vaccination, monoclonal gammopathy, vitamin B12 deficiency, coeliac disease, and diseases of the connective tissue, inflammatory bowel and thyroid. Sensory neuropathy remained undetermined in 50% of the patients.

Correlation of clinical and demyelinating features in patients with neuropathy of otherwise unknown etiology.

PURPOSE: To correlate the electrodiagnostic and clinical features of patients with demyelinating abnormalities and neuropathy of otherwise unknown etiology. METHODS: We examined the records of patient with demyelinating abnormalities and no other cause for neuropathy that were evaluated in our electrophysiology laboratory over the course of a year, to correlate the clinical and electrodiagnostic features. RESULTS: Eight percent of all patients had one or more demyelinating abnormalities. Demyelinating features were significantly more numerous in generalized or asymmetric neuropathy than in distal polyneuropathy. The peroneal nerve was the most commonly affected in all phenotypes, and none of the patients with distal neuropathy had F-wave prolongation in the demyelinating range. CONCLUSIONS: The number and type of demyelinating abnormalities in patients with polyneuropathy vary with the clinical phenotype. The clinical presentation should be considered in developing or evaluating electrodiagnostic criteria for demyelinating neuropathies.

Purification, crystallization and preliminary diffraction study of beta-galactosidase from Penicillium sp.

Crystals of an extracellular beta-galactosidase from Penicillium sp. (MW = 120 +/- 5 kDa) have been obtained from a sodium phosphate buffer using PEG as precipitant. The crystals belong to the tetragonal space group P4(1)or P4(3), with unit-cell parameters a = b = 110.82, c = 161.28 A, and diffract to 1.85 A resolution at a synchrotron source.

Are malaria films requested appropriately? A study of all film requests in one health district.

In a 12-month period 238 patients had blood films examined for malaria parasites in a London district general hospital. All the available medical records of these patients were studied. The ethnic origin and country from which the patients had travelled were typical of an area with a large immigrant population. 27 of the films were positive. 39 were judged to have been requested inappropriately, usually because an adequate travel history had not been taken. Imported malaria is an important problem in this health district and contributes significantly to the laboratory workload.

Malaria in Brent: successful treatment in the community.

40 cases of malaria seen in an 18 month period were reviewed. The clinical diagnosis was made by the general practitioner or casualty officer in 85%, and 45% of these were treated and discharged without further referral. In an area where a high awareness of malaria exists, uncomplicated Plasmodium vivax infection can be treated safely in the community. Primaquine should be given for the exo-erythrocyte stage and patients screened for glucose-6-phosphate dehydrogenase deficiency before this.