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Published on: November 9, 2017
Brucella: a cause of peripheral neuropathy
Gulnihal Kutlu1, Gunay Tuncer Ertem, Ozlem Coskun
1Department of Neurology, Ankara Training & Research Hospital, Ministry of Health, Ankara, Turkey. gulnihalkutlu@yahoo.com
Abstract:
Brucellosis is a common infectious disease in Mediterranean countries. We evaluated the peripheral nerve involvement in patients with brucellosis. Thirty-eight patients with brucellosis were examined. Four of them were excluded because of B(12) deficiency and diabetes mellitus. Thirty-four patients were included. The average age was 43.08 +/- 15.3 years. Patients were divided into two groups according to the abnormality in their peripheral nervous system (PNS) examination. All patients underwent nerve conduction and needle electromyography EMG studies. Twenty normal healthy subjects were used as a control group. Axonal sensorimotor neuropathy was determined in 12 patients who also had abnormality in PNS examination. After 6 months of treatment, nerve conduction studies were nearly normal in these patients. The EMG findings of the remaining 22 patients were normal, as well as the clinical examination. However, the motor conduction velocities of median (p < 0.001), peroneal (p < 0.001), and ulnar (p < 0.05) nerves were decreased, F wave latencies were prolonged in the posterior tibial and peroneal nerve, and distal latency was also prolonged in the posterior tibial nerve (p < 0.05) when compared to healthy subjects. Sensory conduction velocities of the median (p < 0.001), ulnar and sural (p < 0.05) nerve were also decreased. Brucellosis may be considered as a cause of clinical or subclinical peripheral neuropathy and should be evaluated especially in endemic areas.
Insights
Brucellosis can cause peripheral nerve damage, including axonal sensorimotor neuropathy. Early evaluation is crucial, especially in endemic regions, as nerve function can improve with treatment.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Neuroscience
Background:
- Brucellosis is a prevalent infectious disease in Mediterranean regions.
- Peripheral nerve involvement in brucellosis patients requires further investigation.
Purpose of the Study:
- To evaluate peripheral nerve involvement in patients diagnosed with brucellosis.
- To identify clinical and subclinical neuropathy in brucellosis.
Main Methods:
- Thirty-four brucellosis patients underwent neurological examinations, nerve conduction studies (NCS), and needle electromyography (EMG).
- A control group of 20 healthy subjects was included for comparison.
- Patients were categorized based on peripheral nervous system (PNS) examination findings.
Main Results:
- Twelve patients exhibited axonal sensorimotor neuropathy, with nerve conduction studies normalizing after treatment.
- Twenty-two patients had normal EMG and clinical exams but showed decreased motor and sensory nerve conduction velocities and prolonged F-wave latencies compared to controls.
- Subclinical electrophysiological abnormalities were detected in brucellosis patients.
Conclusions:
- Brucellosis can lead to both clinical and subclinical peripheral neuropathies.
- Peripheral neuropathy should be considered in the differential diagnosis of patients with brucellosis, particularly in endemic areas.
- Nerve conduction studies and EMG are valuable tools for detecting subclinical nerve involvement.
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