Adult Arnold-Chiari malformation type I associated with an aseptic meningeal reaction
✍ Scribed by M. Seth Hochman; Steven A. Kobetz
- Publisher
- John Wiley and Sons
- Year
- 1981
- Tongue
- English
- Weight
- 217 KB
- Volume
- 10
- Category
- Article
- ISSN
- 0364-5134
No coin nor oath required. For personal study only.
✦ Synopsis
Sun and Streib [3]
, in their review of the literature on diabetic thoracoabdominal neuropathy, accidentally omitted a large series of this entity. Ellenberg Ill reported 40 patients with "diabetic truncal mononeuropathy" in 1978. Characteristics of his cases differed in some aspects from the 5 patients presented by Sun and Streib and the 12 cases they summarized.
All series suggest that this neuropathy occurs in an older age group [1-3]. There is an equal sex distribution, although all 5 of Sun and Streib's patients were female. Most cases occur in adult-onset diabetics whose disease is of long duration, although occasionally juvenile diabetics are affected. In Ellenberg's patients no motor involvement was seen, the nerve involvement was almost always unilateral and asymmetrical, and the prognosis was good. Diabetic peripheral neuropathy was usually associated, as other series suggest as well [2].
Nerve conduction velocities may be abnormal [ 1-31, usually with alteration in sensory latency or amplitudes present [2]. Electromyographic evaluation [2] demonstrates involvement of the paraspinal muscles, as Drs Sun and Streib suggest [3]. If fibrillations or positive waves are limited to the symptomatic level, they can support the clinical diagnosis of diabetic truncal (thoracoabdominal) mononeuropathy (neuropathy).