World Health Organization : Technical Report Series, No. 654, (Part 1): Peripheral Neuropalhies

By R. Di Perri

Book Id: WPLBN0000170242
Format Type: PDF eBook
File Size: 2.7 MB
Reproduction Date: 2005

Title:	World Health Organization : Technical Report Series, No. 654, (Part 1): Peripheral Neuropalhies
Author:	R. Di Perri
Volume:
Language:	English
Subject:	Health., Public health, Wellness programs
Collections:	Medical Library Collection, World Health Collection
Historic Publication Date:
Publisher:	World Health Organization


Citation APA MLA Chicago Perri, R. D. (n.d.). World Health Organization : Technical Report Series, No. 654, (Part 1). Retrieved from http://self.gutenberg.org/

Description
Medical Reference Publication

Excerpt
1. INTRODUCTION Involvement of peripheral nerves in disease states-a major cause of disabling morbidity-is common in all parts of the world. The putative etiological factors (including genetic, nutritional, metabolic, and toxic factors) are diverse, numerous, and bewildering in the complexity of their modes of action and interaction as well as in the nature of the biochemical and structural lesions produced. Even in diseases of the peripheral nerves, such as leprosy (primarily a peripheral neuropathic disease) and acute infective polyneuritis (also known as acute infective polyneuropathy, or Guillain-Barre syndrome, or acute polyradiculoneuritis (see page 63), among other synonyms), of which the pathogenesis is fairly well understood, treatment is still far from being satisfactory and preventive measures are still hardly feasible. There is a need for a better understanding of the structure and function of the neurons and their axons, on the one hand, and the relationship between the axons and the Schwann cells, on the other. It is still not fully understood how many of the etiological factors in peripheral neuropathies affect the functions of the neurons, producing the metabolic insult, end-result, and neuropathological changes. In many countries the magnitude and specificity of the numerous risk factors are unknown or only inferred. It is therefore of great importance to :

Table of Contents
CONTENTS Page 1 . Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7 2 . Cellular biology of peripheral nerves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 2.1 Functional anatomy of peripheral neurons: axonal transport mechanisms . 8 2.2 Chemistry and chemical pathology of peripheral nerves . . . . . . . . . . . . . . . . 15 2.3 Gangliosides and their relationship to neuronal function . . . . . . . . . . . . . . . 27 3 . General clinical aspects of peripheral neuropathies . . . . . . . . . . . . . . . . . . . . . . . . 35 3.1 Classification and approach to the diagnosis of human neuropathies . . . . . 35 3.2 Epidemiology of peripheral neuropathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46 4 . Infectious. toxi.infectious. and immunological factors in peripheral neuropathies 54 4.1 Viral factors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54 4.2 Rabies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 4.3 Herpeszosfer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57 4.4 Leprosy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... . . . . . . . . . . . . . . . . . . . . 59 4.5 Diphtheria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62 4.6 Acute infective polyneuritis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 63 5 . Nutritional factors in peripheral neuropathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65 5.1 Mode of action of vitamins on peripheral-nerve metabolism: basis for th understanding of some nutritional neuropathies . . . . . . . . . . . . . . . . . . . . . . . 65 5.2 Multifactorial etiology of tropical neuropathies . . . . . . . . . . . . . . . . . . . . . . . 70 6 . Environmental neurotoxins . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 6.1 General remarks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75 6.2 Specificdrugs . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77 6.3 Miscellaneous chemical and biological agents . . . . . . . . . . . . . . . . . . . . . . . . . 82 7 . Metabolic and genetic neuropathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 7.1 Diabetic neuropathies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 88 7.2 Endocrine neuropathies . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . 93 7.3 Some genetic neuropathies associated uith disturbances of complex lipid metabolism . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97 7.4 Peroneal muscular atrophies (Charcot-Marie-Tooth syndrome) . . . . . . . . . . 104 8 . Traumatic. mechanical. and surgical aspects of peripheral nerves . . . . . . . . . . . . 105 8.1 Nerve pathology in joint diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105 8.2 Peripheral-nerve injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107 9 . Conclusions and recommendations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 113 References . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116 Selected bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 138