Clinical and Electrophysiological Evaluation of Neuropathy in Rheumatoid Arthritis.

Sundar, S (2007) Clinical and Electrophysiological Evaluation of Neuropathy in Rheumatoid Arthritis. Masters thesis, Madras Medical College, Chennai.

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Abstract

Rheumatoid arthritis is a chronic inflammatory polyarthritis leading to deformities. It is defined by the American College of Rheumatology (ACR) as a diffuse connective disease, and around 40% of patients are considered to have characteristic extra-articular manifestations. The predominant extra-articular manifestations involve the lungs, nerves, blood vessels, heart, skin, eyes1. Neuropathy is one of the important extra-articular manifestations of Rheumatoid arthritis and can have crippling consequences44,72. Subjective and objective assessment of neuropathy in RA is difficult due to concomitant joint disease as both may contribute to muscle wasting and weakness. Neuropathy in RA is most commonly due to vasculitis, entrapment or due to drugs. Various types of neuropathy can occur from mononeuritis multiplex to severe sensorimotor neuropathy. Although there might be some recovery of the predominant sensory neuropathy, severe mixed neuropathy or mononeuritis multiplex appears to be a reflection of an aggressive vasculitic form of RA and is associated with poor prognosis. Hence it is imperative that rheumatoid neuropathy is detected at the earliest when it is sub clinical. Electrophysiological studies are important for confirmation of clinical suspicion and to detect sub clinical neuropathy. Paucity of Indian literature on rheumatoid neuropathy creates a lacuna in the critical evaluation and discussion of the subject. Hence this study was carried out to find out the incidence and pattern of neuropathy in our RA patients. Another aim was to find out any correlation between neuropathy and disease parameters like duration, activity, rheumatoid factor. One fourth of the patients with Rheumatoid arthritis had evidence of neuropathy. Non entrapment neuropathy was the predominant type of neuropathy among which sensorimotor type was the most common one. Among the disease parameters, only male sex and Neuropathy Deficit Score (NDS) were found to be significantly correlated with rheumatoid neuropathy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Clinical ; Electrophysiological Evaluation ; Neuropathy ; Rheumatoid Arthritis.
Subjects: MEDICAL > Neurology
Depositing User: Kambaraman B
Date Deposited: 28 Jun 2017 10:16
Last Modified: 28 Jun 2017 10:16
URI: http://repository-tnmgrmu.ac.in/id/eprint/555

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