Diagnosis of small-fiber neuropathy using various autonomic function tests.
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- Obayashi Konen
- Department of Morphological and Physiological Sciences, Graduate School of Health Sciences, Kumamoto University
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- Ando Yukio
- Department of Neurology, Graduate School of Health Sciences, Kumamoto University
Bibliographic Information
- Other Title
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- 多角的自律神経機能検査法をもちいた小径線維ニューロパチーの診断
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Abstract
It is well known that transthyretin-related familial amyloidotic polyneuropathy (TTR-FAP) and diabetic peripheral neuropathy are characterized by early selective involvement of small nerve fibers. However, early diagnosis of these diseases is not easy because prominent early diagnostic markers for small fiber neuropathies have not established. Thus, we adopted several methods to evaluate autonomic function accurately for detecting the onset of small-fiber neuropathy, such as laser-Doppler flowmetry, sweating tests using capsule type sweating ratemeter, morphological check of sweat gland, electrogastrography, density check of small-fiber and gastrointestinal interstitial cells of Cajal, R-R interval study, 123I-MIBG myocardial scintigraphy, and head-up tilt test to check the overshoot phenomenon. These tests may indicate very early stage of small-fiber neuropathies in asymptomatic mutated TTR carriers or impaired glucose tolerance patients. Moreover, assessment of the pain thresholds by preferential stimulation of C and Aδ fibers are particularly useful tools for diagnosing the onset of small-fiber neuropathies in addition to the autonomic testing.
Journal
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- Rinsho Shinkeigaku
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Rinsho Shinkeigaku 54 (12), 1044-1046, 2014
Societas Neurologica Japonica