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Related Concept Videos

Diabetic Neuropathy01:22

Diabetic Neuropathy

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DefinitionDiabetic neuropathy is nerve damage caused by long-standing diabetes mellitus. It results directly from prolonged high blood sugar levels.PathophysiologyThe pathophysiology of diabetic neuropathy involves both metabolic and vascular disturbances triggered by chronic hyperglycemia.Metabolic injury: Elevated glucose levels activate the polyol pathway within nerve cells, leading to the accumulation of sorbitol and fructose. This increases oxidative stress, disrupts normal nerve...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Related Experiment Video

Updated: Apr 21, 2026

Three-dimensional Imaging of Nociceptive Intraepidermal Nerve Fibers in Human Skin Biopsies
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Neuropathy in elderly: lessons learnt from nerve biopsy.

Lawrence Anish1, Madhu Nagappa1, Anita Mahadevan2

  • 1Department of Neurology, NIMHANS, Bangalore, Karnataka 560029, India.

Age and Ageing
|November 3, 2014
PubMed
Summary

Nerve biopsy is a valuable tool for diagnosing peripheral neuropathy in elderly patients, aiding in treatment decisions for 81% of individuals. This diagnostic approach helps identify treatable conditions, improving patient management.

Keywords:
diabeteselderly neuropathyleprosynerve biopsyolder peoplevasculitis

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Area of Science:

  • Neurology
  • Pathology
  • Geriatrics

Background:

  • Peripheral neuropathy is a common condition in the elderly, often presenting diagnostic challenges.
  • Accurate diagnosis is crucial for effective management and improving patient outcomes.

Purpose of the Study:

  • To evaluate the diagnostic, therapeutic, and prognostic utility of nerve biopsy in elderly individuals with peripheral neuropathy.
  • To assess the impact of nerve biopsy findings on clinical management decisions.

Main Methods:

  • Retrospective review of clinico-pathological data from 100 elderly subjects (aged 65+) with peripheral neuropathy who underwent nerve biopsy between 2002 and 2011.
  • Analysis of biopsy results, including diagnostic yield, confirmation of pre-biopsy diagnoses, and identification of new diagnoses.

Main Results:

  • Nerve biopsy provided a definitive diagnosis in 24% of cases, with key findings including vasculitis, leprosy, and acute inflammatory demyelinating polyradiculoneuropathy.
  • Biopsy findings were essential or helpful in guiding therapeutic management for 81% of patients.
  • In patients without a pre-biopsy diagnosis, nerve biopsy was essential in 17.5% and helpful in 52.5%, revealing conditions like vasculitis and ischemic neuropathy.

Conclusions:

  • Nerve biopsy is a useful diagnostic tool for peripheral neuropathy in the elderly, aiding in the identification of treatable disorders.
  • The procedure significantly influences patient management, particularly in cases with previously undiagnosed neuropathies.
  • The etiological profile observed in this cohort may be representative of similar elderly populations with neuropathies.