Complex regional pain syndrome (CRPS) is a chronic regional pain disorder that most frequently affects the limbs. It is characterized by hyperalgesia, allodynia, edema, motor disturbance, and vasomotor instability, and typically occurs following surgery or trauma. In type-I CRPS there is no confirmed nerve injury, while peripheral nerve injury is present in type-II CRPS. The multifactorial pathophysiological etiology of CRPS includes inflammation, autoimmune responses, abnormal cytokine production, autonomic dysfunction, altered blood flow, psychological factors, and central cortical reorganization. There are no specific laboratory diagnostic tools for CRPS, and so it is diagnosed clinically. The Budapest criteria are currently the most-accepted diagnostic criteria.

Citations

• Complex Regional Pain Syndrome: Updates and Current Evidence
  Yeng F. Her, Eva Kubrova, Marissa Dombovy-Johnson, Mariam ElSaban, Karson Mostert, Ryan S. D’Souza
  Current Physical Medicine and Rehabilitation Repor.2024; 12(1): 50.     CrossRef
• Task-based and Magnified Mirror Therapy for Unilateral Spatial Neglect among post-stroke subjects: Study protocol for a randomized controlled trial
  Kamal Narayan Arya, Shanta Pandian, Divya Pandey, G. G. Agarwal, Neera Chaudhary, Monika Halicka
  PLOS ONE.2024; 19(1): e0296276.     CrossRef
• Diagnosis and Management of Knee Arthrofibrosis and Associated Pain-Related Fear Using Multidimensional Clinical Reasoning and Exposure In Vivo Concept: A Case Report
  Mohammad Jamali, Kevin McEnroy, Logan W. Gaudette, Zafeer Baber, Ryan J. Stoddard
  JOSPT Cases.2024; 4(3): 121.     CrossRef
• Nuclear Imaging in Orthopaedic Practice
  Alvaro Ibaseta, Ahmed Emara, Ignacio Pasqualini, Benjamin Jevnikar, Ceylan Colak, Oguz Turan, Shujaa T. Khan, Matthew E. Deren, Nicolas S. Piuzzi
  JBJS Reviews.2024;[Epub]     CrossRef

Ultrasonography is currently being developed as a tool for evaluating peripheral neuropathy. It is one of the painless and least-invasive methods of medical diagnostic testing that yields anatomic views of the nerves and their surrounding structures. Here I first describe the equipment settings and technique for nerve ultrasound along with typical sonographic findings for normal nerves. I then address frequently used parameters for nerve measurements that facilitate diagnoses of focal and generalized neuropathies.

Citations

• A soft, scalable and adaptable multi-contact cuff electrode for targeted peripheral nerve modulation
  Valentina Paggi, Florian Fallegger, Ludovic Serex, Olivier Rizzo, Katia Galan, Alice Giannotti, Ivan Furfaro, Ciro Zinno, Fabio Bernini, Silvestro Micera, Stéphanie P. Lacour
  Bioelectronic Medicine.2024;[Epub]     CrossRef

Noninvasive stimulation of the nervous system for treating chronic neuropathic pain has received attention because of its tolerability and relative efficacy. Repetitive transcranial magnetic stimulation (rTMS) is a representative method of noninvasive brain stimulation. Evidence-based guidelines on therapeutic use of rTMS have been proposed recently for several neurological diseases. These guidelines recommend treating neuropathic pain by applying high-frequency (≥ 5 Hz) rTMS to the primary motor cortex contralateral to the painful side. This review summarizes the mechanisms and guidelines of rTMS for treating neuropathic pain, and proposes directions for future research.

Citations

• Efficacy of repetitive transcranial magnetic stimulation for phantom limb pain- a meta analysis of randomized controlled trials
  FNU Chandni, FNU Savanti, Rohit Kumar, Murk Raj, Aakash Kumar, Aashish Kumar, Sejal Kinger, Sahil Kumar, Himat Rai, Afsana Ansari Shaik, Muhammad Sohaib Asghar
  Neurological Sciences.2025; 46(5): 2019.     CrossRef
• Impact of Titanium Skull Plate on Transcranial Magnetic Stimulation: Analysis of Induced Electric Fields
  Mai Lu, Shoogo Ueno
  Life.2024; 14(5): 642.     CrossRef
• Synaptic sensitization in the anterior cingulate cortex sustains the consciousness of pain via synchronized oscillating electromagnetic waves
  Richard Ambron
  Frontiers in Human Neuroscience.2024;[Epub]     CrossRef
• Dualism, Materialism, and the relationship between the brain and the mind in experiencing pain
  Richard Ambron
  Neuroscience.2024; 561: 139.     CrossRef

Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic recurrent acquired immune-mediated disease of the peripheral nerves that presents with progressive sensory and motor deficits in all four limbs. Cranial nerve involvement is not as common as in Guillain-Barre syndrome, and central nervous system involvement including optic neuritis has rarely been reported in patients with CIDP. We recently experienced a case with classic CIDP involving bilateral facial and trigeminal nerves, right lower cranial nerves, and the right optic nerve.

Primary central nervous system lymphoma (PCNSL) is a type of non-Hodgkin lymphoma confined to the central nervous system. Its diagnosis requires a stereotactic biopsy, which is an invasive procedure. Cerebrospinal fluid (CSF) analysis is less invasive and easier to perform than a stereotactic biopsy. We hereby report a PCNSL case diagnosed using CSF analysis and treated with systemic chemotherapy.

Posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) are relatively uncommon neurological disorders. These two independent syndromes can be concurrent as a part of a continuum process; however, the specific mechanism is not well known. Although the relationship between RCVS and PRES is currently unclear, they could share a common pathophysiology. This case report aimed to determine the pathophysiology underlying the co-occurrence of PRES and RCVS in a patient with an acute exacerbation of chronic obstructive pulmonary disease.

Some cases of myasthenia gravis (MG) with abnormal spontaneous activity (ASA) in needle electromyography (EMG) have been reported, but the associated clinical characteristics remain to be fully elucidated. We report the case of a 36-year-old male with MG in whom ASA was observed. This study highlights that ASA may appear in needle EMG in patients with severe MG who predominantly have bulbar and/or respiratory involvement. Care is needed because this often accompanies myopathic features and can be misdiagnosed as myopathy.

Diffuse large B-cell lymphoma (DLBCL) is the most common type of non-Hodgkin’s lymphoma. Although progressive lymphadenopathy is a typical feature, extranodal involvement may also occur, including the gastrointestinal tract, skin, bone, thyroid, and testes. Central nervous system invasion is rare, so differentiating it from diseases such as inflammatory demyelinating disorder or infection is essential. DLBCL is therefore a challenge to diagnose, especially when the first findings are neurological symptoms. We report an unusual case of DLBCL that presented as transverse myelitis.

Vestibular dysfunction has rarely been reported in MELAS syndrome. A 40-year-old male with long-term diabetes and hearing loss experienced a stroke-like episode with hemisensory disturbance and lactic acidosis. Brain MRI showed temporo-parieto-occipital cortical lesions, and a final diagnosis was made of MELAS syndrome with the mitochondrial 3243A>G mutation. Neuro-otologic evaluations revealed anterior-canal-sparing bilateral impairments of the vestibulo-ocular reflex in the video head impulse test and no caloric paresis. This unique pattern of vestibular dysfunction may aid in diagnosing MELAS syndrome.

AGel amyloidosis is an autosomal dominantly inherited disease caused by a GSN mutation, and affected patients typically present with the clinical triad of corneal lattice dystrophy, progressive cranial neuropathy, and cutis laxa. We report a Korean family with AGel amyloidosis with predominant manifestations of facial and bulbar muscle weakness. Whole-exome sequencing revealed a common missense mutation (p.Asp214Tyr) in GSN. This case strongly suggests that AGel amyloidosis should be considered when a patient presents with progressive facial and bulbar palsies.

Posterior reversible encephalopathy syndrome (PRES) is a rare condition manifested by inflammation in certain areas of the brain. Rhabdomyolysis with acute kidney injury (AKI) complicated by PRES is rarely reported. A 26-year-old female presented with neurological symptoms, high blood pressure, and AKI. Her symptoms improved with blood pressure control, anticonvulsant drug medications, and renal replacement therapy. This case demonstrates that PRES should be considered in the differential diagnosis of patients who have rhabdomyolysis with AKI accompanied by neurological symptoms, including headaches and convulsions.

Idiopathic hypertrophic pachymeningitis (IHP) is a rare disease involving localized inflammatory thickening of the intracranial or spinal dura mater without an identified cause. Seizure is a very unusual presentation of IHP. We present a 58-year-old-female patient with seizures caused by IHP. This case indicates that although IHP is rare, it has the potential to cause seizures.

Neurological complications attributed to coronavirus disease-19 (COVID-19) infection have been reported including acute disseminated encephalomyelitis, Guillain-Barré syndrome, and so on. Herein, we report a 49-year-old woman presented with acute encephalopathy and paraplegia simultaneously after COVID-19 infection. Brain magnetic resonance imaging (MRI) showed symmetric hyperintense basal ganglia lesions on T2-weighted imaging. Cerebrospinal fluid pleocytosis, motor axonal neuropathy and enhancement of conus medullaris nerve roots on spine MRI were observed. We treated her with high-dose corticosteroid and intravenous immunoglobulin.

We describe the case of a 22-year-old female complaining of ophthalmoplegia, which deteriorated with seizure. Leigh syndrome (LS) was diagnosed by identifying the m.9176T>C mutation. She improved with vitamin cocktail therapy plus intravenous methylprednisolone, and had an excellent prognosis. This was the first case of an adult patient with LS presenting with the m.9176T>C mutation and reporting cortical symptoms, which in this case comprised cortical vision loss, and cortical, basal ganglia, and brainstem signal changes on magnetic resonance imaging.