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Diabetic Pseudotabes


Presentation

  • The fact that the incidence of diabetes is very high, at present 1 %-2 % of the population is affected and their number is gradually increasing - dis plays the timeliness of this subject.[books.google.de]
  • . // Taber's Cyclopedic Medical Dictionary (2009);2009, Issue 21, p176 A definition of the term "Argyll Robertson pupil," which pertains to a symptom present in paralysis and locomotor ataxia, is presented.[connection.ebscohost.com]
  • Small fiber modalities are involved earlier than large fiber deficits (burning; lancinating pain; deep muscle ache); later loss of vibration and proprioception in the legs-if severe may present as diabetic pseudo-tabes.[neurodiffdx.com]
  • PowerPoint Presentation: Small epidermal nerve fibers stain positive for the neuronal antigen protein gene product 9.5 (PGP 9.5). Treatment : Strict glucose control from the time of diagnosis of DM is the most important aspect of treatment.[authorstream.com]
Falling
  • Insulin requirements fall to prepregnancy levels within the first 24 hours after delivery. The order in which obese people with type 2 diabetes eat their food can affect their blood sugar levels a small study suggests.[gospelblues.eu]
  • […] acute symptoms indicating CHOA onset and progress (Fig. 15.8 ) Fig. 15.8 Foot in the CHOA acute stage. ( a ) Acute CHOA in the region of the ankle with a marked swelling of soft structures; ( b ) involvement of the left foot with swelling and subsequent fall[musculoskeletalkey.com]
  • […] exact onset of the Charcot spine is notknown but it was not present immediately afterthe accident when she fell on her back in 1945 .That some changes were taking place and someinjury had resulted can be deduced from thecontinual pain subsequent to this fall[docslide.com.br]
  • Plasma insulin levels fall, and insulin secretory responses to glucose become impaired during surgery. 17 – 19 The mechanism of the impaired β-cell responsiveness during surgery is unclear, and the defect is poorly correlated with ambient intraoperative[spectrum.diabetesjournals.org]
  • Plasma insulin levels fall, and insulin secretory responses to glucose become impaired during surgery. (17-19) The mechanism of the impaired [beta]-cell responsiveness during surgery is unclear, and the defect is poorly correlated with ambient intraoperative[go.galegroup.com]
Physician
  • .), FACP, Pro Vice-Chancellor, Global Research, University of Newcastle, Australia Professor of Medicine, Faculty of Health and Medicine, University of Newcastle, Australia President, Royal Australasian College of Physicians Chair-Elect, Committee of[books.google.de]
  • Malik is a Professor of Medicine at Weill Cornell Medical College, Qatar and Honorary Professor of Medicine and Consultant Physician in the Centre for Endocrinology and Diabetes, Central Manchester University Teaching Hospitals Foundation Trust and University[books.google.com]
  • With this in mind, physicians should always maintain an optimistic outlook in dealing with patients with these afflictions. Cranial neuropathy Palsies of the third cranial nerve (diabetic ophthalmoplegia) are painful in about 50% of cases.[oncohemakey.com]
  • Many patients and physicians know that pain can be diminished by cooling the feet [9, 22] and unsatisfactory attempts have been made in the past to reduce blood flow [23].[documents.tips]
  • If admission is not feasible, a physician or diabetes nurse practitioner should work with the patient to optimize self-monitoring of blood glucose (SMBG) values in the days preceding the planned surgery.[spectrum.diabetesjournals.org]
Disability
  • Complications of diabetes (disability, vision disorders, heart disease, infection, etc.); medical care for diabetes; economic aspects, including health insurance & health care costs; & diabetes in special populations, including Blacks, Hispanics, Asian[books.google.de]
  • Stage III - Disabling neuropathy - Disabling symptoms and 2 or more functional abnormalities. Vascular hypoxic changes are manifested as 1. Basement membrane thickening & reduplication 2. Endothelial cell swelling and pericyte degeneration 3.[diabetescare.page.tl]
  • Minimum criteria for the clinical diagnosis of neuropathy according to the Neuropathy Symptom Score and Neuropathy Disability Score are: Moderate signs with or without symptoms; or Mild signs with moderate symptoms.[oncohemakey.com]
  • Diabetic neuropathy can be disabling as a consequence of autonomic dysfunction or discomfort.[enotes.tripod.com]
  • […] claudication symptoms or pedal pulses that are decreased or absent Patients with positive ankle-brachial index should be referred to a specialist for further assessment and management Foot ulceration and amputation are frequent causes of morbidity and disability[specialty.mims.com]
Fatigue
  • These include criteria for the diagnosis of multiple sclerosis, dementia of Lewy-body type, frontal lobe dementias, chronic fatigue syndrome, and inflammatory neuropathies.[books.google.com]
  • Here, I show that her physical ailments spanned 30 years and included sore mouth, pallor, paresthesias, the Lhermitte symptom, fever, headaches, fatigue, resting tachycardia, edema, episodic weight loss, progressive weakness, ataxia, and visual impairment[muse.jhu.edu]
  • They include frequent urination (polyuria), excessive thirst (polydipsia), fatigue, blurred vision, tingling or loss of feeling in the hands and feet (diabetic neuropathy), sores that do not heal well, and weight loss.[icdlist.com]
Chronic Fatigue Syndrome
  • These include criteria for the diagnosis of multiple sclerosis, dementia of Lewy-body type, frontal lobe dementias, chronic fatigue syndrome, and inflammatory neuropathies.[books.google.com]
Vascular Disease
  • Many other medical and surgical disorders affect the spinal cord, including vascular disease, decom pression sickness, degenerative disorders and multiple sclerosis. In this book Dr. Critchley and Dr.[books.google.de]
  • […] eg. stab wound · carotid or aortic aneurysm · cervical sympathectomy HORNER'S SYNDROME AND 12 TH NERVE PALSY jugular foramen lesions: · meningioma · neurofibroma · glomus jugulare tumour other: · syringomyelia / syringobulbia · brainstem vascular disease[sinoemedicalassociation.org]
  • disease  History of ulcers or amputation  Severe nail pathology DISTAL SENSORIMOTOR POLYNEUROPATHY COMPLICATION 9 DISTAL SENSORIMOTOR POLYNEUROPATHY 10  Pure autonomic neuropathy  Range from subclinical impairment of CVS reflex and sudomotor function[slideplayer.com]
  • .: diabetic Neuropathy: a metabolic or a vascular disease? diabetes 14:1,1965. 4. MULDER.D.: Diabetic neuropathies, GP.2:113.1964. 5. LA MONTAGNE. et al: Electrophysiological Neuropathy, J. Neurol & Neurosurg, sy. 33:442-452. 1970.[revistaendocrino.org]
Heart Disease
  • Relationship of plasma insulin levels to the incidence of myocardial infarction and coronary heart disease mortality in a middle-aged population. ‏[books.google.com]
  • Complications of diabetes (disability, vision disorders, heart disease, infection, etc.); medical care for diabetes; economic aspects, including health insurance & health care costs; & diabetes in special populations, including Blacks, Hispanics, Asian[books.google.de]
  • They realised that heart disease can manifest differently in men and women — they may have different risk profiles, symptoms, or treatment needs on admission to hospital.[scidev.net]
  • If blood sugar levels are not controlled through medication or diet, type 2 diabetes can cause long-lasting (chronic) health problems including heart disease and stroke; nerve damage; and damage to the kidneys, eyes, and other parts of the body. [ Read[icdlist.com]
Orthostatic Hypotension
  • AUTONOMIC NEUROPATHY 12 Orthostatic hypotension up head position drinking before bedtime elastic body stocking plasma volume expansion : fludrocortisone  -agonist : midodrine Treatment ANS dysfunction AUTONOMIC NEUROPATHY 13 Delay gastric emptying time[slideplayer.com]
  • Autonomic neuropathy (Orthostatic hypotension) treated with high salt diet, elastic stockings and oral fludrocortisone. Diabetic diarrhoea treated with atropine loperamide and diphenoxylate.[diabetescare.page.tl]
  • hypotension and sexual dysfunction Mechano dynamic and static allodynia; hyperalgesia are common Cramps of the feet and thigh (neurogenic cramps) Differential diagnosis of burning feet DM HIV (Distal neuropathy) INH Pyridoxine excess or deficiency Uremia[neurodiffdx.com]
  • hypotension), GI ( constipation ), genitourinary ( impotence, reduced vaginal lubrication), and sudomotor (distal anhidrosis) systems.[mitchmedical.us]
  • hypotension Treatment is generally focused on alleviating symptoms Peripheral nerve dysfunction in diabetic patients is considered only after other causes have been ruled out Chronic sensorimotor distal polyneuropathy and autonomic neuropathy are the[specialty.mims.com]
Vision Disorder
  • Complications of diabetes (disability, vision disorders, heart disease, infection, etc.); medical care for diabetes; economic aspects, including health insurance & health care costs; & diabetes in special populations, including Blacks, Hispanics, Asian[books.google.de]
Foot Ulcer
  • Young MJ, Manes C, Boulton AJM: Vibration perception threshold predicts foot ulceration. Diabet Med 1992;9(suppl 2):542.[karger.com]
  • ulcer due to type 2 diabetes mellitus Neuropathic midfoot AND/OR heel ulcer due to type 2 diabetes mellitus Neuropathic toe ulcer due to type 2 diabetes mellitus Neuropathy due to type 2 diabetes mellitus Peripheral autonomic neuropathy due to diabetes[icd9data.com]
  • ulcer, DM 2 w diabetic neuropathic heel and midfoot ulcer, DM 2 w diabetic neuropathic toe ulcer, DM 2 w diabetic neuropathy, DM 2 W diabetic peripheral neuropathy, DM 2 w diabetic peripheral sensory neuropathy, DM 2 W diabetic polyneuropathy, DM 2 with[healthresearchfunding.org]
  • Strongly endorsed is the use of the 10-g monofilaments for screening of feet to detect sensation loss, with the goal of improving diabetic management and prevention of foot ulcers and neurogenic arthropathy.[paperity.org]
  • ulcers in high-risk patients Management of comorbidities, evaluation of vascular status and treatment, assessment of lifestyle factors, assessment of ulcer, management of tissues, and relief of pressure are important in treating diabetic foot ulcers[specialty.mims.com]
Neuropathic Arthropathy
  • arthropathy Unlike syphilis diabetic neuroapthic arthropathy involves small joints of feet Diabetic pseudotabes Diabetic lumbosacral radiculoplexus neuropathy (Bruns-Garland syndrome): Clinical features Males more frequently affected than females Pain[authorstream.com]
Joint Deformity
  • […] diabetic pseudotabes a form of diabetic neuropathy with symptoms in the lower limbs such as sensory loss, ataxia, ulceration, and sometimes lancinating pains and joint deformities; sometimes Argyll Robertson pupils occur. Called also diabetic tabes.[medicine.academic.ru]
  • In the prepenicillin era, far-advanced tabes was observed with complete incapacitation owing to joint deformity, loss of bladder control, blindness, ataxia, and deafness. Tabes may burn out with time, even in the absence of treatment.[std-aid.com]
Back Pain
  • pain Differences Between Disc Herniations and Boney formations Disc Herniations: Age( UNDER 40,) Boney Change( OVER 50) Backache: Disc( Short duration), Boney change( Long Duration) Straight leg: Disc( Limited), Boney (Often Not affected) Number of Segments[quizlet.com]
Cerebellar Disease
  • Entries on cerebellar diseases, peripheral neuropathies, various dementias, diagnostic tests (both clinical and laboratory), forms of cerebral edema, dissociative signs and syndromes - all these and many more have been added, expanded, updated or clarified[books.google.com]
  • disease: posterior fossa tumours: acoustic neuroma 1 cerebellar tumours metastases degenerative cerebellar disease: hereditary: ataxia-telangiectasia Friedreich's ataxia alcoholism (Wernicke's encephalopathy) hypothyroidism para-infectious: Guillain-Barre[sinoemedicalassociation.org]
Decreased Proprioception
  • When these manifestations coexist with decreased proprioception in the feet, "pseudotabetic" gait may occur. diabetic tabes An obsolete term for diabetic neuropathy. See also: tabes[medical-dictionary.thefreedictionary.com]
Abnormal Gait
  • DANIL HAMMOUDI.MD SINOE MEDICAL ASSOCIATION DETAILS ARE COMING FOR EACH OF THESE SYNDROME ABNORMAL GAIT (excluding orthopaedic causes) hemiplegia (cerebrovascular accident involving motor cortex or pyramidal tract) parkinsonism (shuffling / festinant)[sinoemedicalassociation.org]
Urinary Incontinence
  • Faecal And Urinary Incontinence The expression of TRPV1 in the bladder is, however, not restricted to afferent nerves urothelium, detrusor muscle and fibroblasts also express TRPV1 in the human bladder 140.[europeanmedical.info]

Workup

Hypertriglyceridemia
  • […] the above targets on maximum tolerated statin therapy: Decrease of 30-40% from baseline Desirable levels of TG is 50 mg/dL) in women Apolipoprotein B (secondary treatment goals) target in patients with high risk for cardiovascular disease is Severe hypertriglyceridemia[specialty.mims.com]

Treatment

  • However, it is particularly important because of the good re sults of appropriate treatment and the unfortunate consequences should the diagnosis be missed.[books.google.de]
  • Neurosyphilis: Diagnosis and Response to Treatment. Musher, Daniel M. // Clinical Infectious Diseases;10/1/2008, Vol. 47 Issue 7, p900 The author reflects on the article about the serological response to treatment of neurosyphilis.[connection.ebscohost.com]
  • Uremic Polyneuropathy: Cause And Treatment Cause 300-2000 molecular weight toxins Treatment: symptomatic renal transplant Second most common cause of neuropathy Pathogenesis direct toxic effect nutritional (B1, B3, B6, B12, folic acid, zinc) Symmetric[quizlet.com]

Prognosis

  • Argyll Robertson Pupil Prognosis Most sufferers do well after treatment. The outcome is poorest for patients who suffer permanent nerve or cardiac damage. Life expectancy is poor due to inability to reverse these symptoms of such advanced disease.[patienthelp.org]
  • H&P( Most Important) Lumbar puncture EMG- Great for determining Myelination Serology Toxicology For This( Protein goes up, cell count is normal Guillain Bare Syndrome/ Treatment: Treatment: Supportive care Plasmapheresis IV IgG No role for steroids Prognosis[quizlet.com]
  • […] intercostal nerve trunk involvement Focal contact hyperesthaesiae in the same area as the pain Truncal Neuropathy PowerPoint Presentation: Focal anterior abdominal wall weakness may be evident Associated weight loss in some cases may be profound Good prognosis[authorstream.com]
  • Causes and prognosis in 4,278 cases of paralysis of the oculomotor, trochlear, and abducens cranial nerves. Am J Ophthalmol 1992 ; 113: 489 – 496. Google Scholar Medline ISI 95. Casellini, CM, Vinik, AI.[journals.sagepub.com]
  • Although severe and tenacious, the pain of proximal motor neuropathy has a good prognosis. Concurrent distal sensory polyneuropathy is frequently present.[oncohemakey.com]

Etiology

  • The etiologies of focal myopathies include traumatic (associated with insulin injection injury) and vascular (related to thigh muscle infarction).[mitchmedical.us]
  • […] large fibers Autonomic neuropathies Small-fiber neuropathies 3 Focal/multifocal neuropathies Cranial neuropathies Thoracoabdominal radiculopathies Focal limb neuropathies Proximal neuropathies Compression and entrapment neuropathies The most important etiologic[oncohemakey.com]
  • Although these theories are still generally accepted, it has been demonstrated that also other etiological factors participating in CHOA development and manifestation have to be taken into account.[musculoskeletalkey.com]

Epidemiology

  • Five general areas are addressed in the 36 chapters: descriptive epidemiology of diabetes in the U.S., including prevalence, incidence, sociodemographic & metabolic characteristics, risk factors for developing diabetes, & mortality.[books.google.de]
  • Nephrology, pathology, internal medicine, diabetology, and other specialists from Germany, the US, and Lebanon address the relationship between the kidney and diabetes and cover the epidemiology, history, pathophysiology, histology, genetic risk factors[freethesaurus.com]
  • Williams DRR: The size of the problem: Epidemiological and economic aspects of foot problems in diabetes; in Boulton AJM, Connor H, Cavanagh PR (eds): The Foot in Diabetes, ed 2. Chichester, Wiley, 1994, pp 15–24.[karger.com]
  • Painful diabetic neuropathy: epidemiology, natural history, early diagnosis, and treatment options. Pain Med 2008 ; 9: 660 – 674. Google Scholar Medline ISI 12. Obrosova, IG.[journals.sagepub.com]
  • Argyll Robertson Pupil Epidemiology This is a rare disease and occurs only sometimes in advanced cases of syphilis and other neurological disorders [ 3 ]. As it is associated with syphilis in most cases, it is uncommon in developing countries.[patienthelp.org]
Sex distribution
Age distribution

Pathophysiology

  • Regarding patients with nerve infarction, the onset is acute and painful, the pathophysiology reflects axon loss, and recovery is often slow and suboptimal.[mitchmedical.us]
  • Nephrology, pathology, internal medicine, diabetology, and other specialists from Germany, the US, and Lebanon address the relationship between the kidney and diabetes and cover the epidemiology, history, pathophysiology, histology, genetic risk factors[freethesaurus.com]
  • : Loss of myelinated nerve fibers Segmental remyelination and demyelination Basement membranes of intraneural capillaries are thickened and duplicated Areas of perivascular inflammation ( said,dyck et al) Biochemical mechanisms Pathology and pathophysiology[authorstream.com]
  • […] non noxious stimuli with sensory deficits, anoxexia, weight loss, depression Generally recovers Hyperglycemic Neuropathy Widespread parasthesias in newly diagnosed cases, after recovery from ketosis Improve rapidly with control, could have a different pathophysiologic[slideserve.com]
  • […] noxious stimuli with sensory deficits, anoxexia, weight loss, depression Generally recovers 13 Hyperglycemic Neuropathy Widespread parasthesias in newly diagnosed cases, after recovery from ketosis Improve rapidly with control, could have a different pathophysiologic[slideplayer.com]

Prevention

  • Avoidable - 67% Emergent - ED Care Needed - Not Preventable/Avoidable - 0% Primary diagnosis of injury 0% Primary diagnosis of mental health problems 0% Primary diagnosis of substance abuse 0% Primary diagnosis of Alcohol 0% Unclassified 0% We Could[medicbind.com]
  • Prevention of foot problems in persons with diabetes.[opther.eu]
  • Controlling your blood sugar can help prevent nerve problems, or keep them from getting worse. Treatment may include pain relief and other medicines.[icdlist.com]
  • Sufferers experience: Fever Chills Sweating Headache Argyll Robertson Pupil Prevention There are no specific prevention guidelines for ARP as yet.[patienthelp.org]

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