Ischemic monomelic neuropathy (IMN) is an uncommon complication of arteriovenous fistula (AVF) surgery that presents with pain, motor weakness, and sensory changes without critical ischemia. This report describes a rare case of successful IMN treatment after AVF surgery. A 61-year-old man with diabetic end-stage kidney disease was admitted for left brachiocephalic AVF surgery. Postoperatively, the patient complained of pain, motor weakness, and numbness in the left hand. However, the radial pulse remained palpable, and the overlying skin remained intact. A nerve conduction study above the wrist revealed reduced compound muscle action potential (CMAP) of the left ulnar nerve and no CMAP of the left median nerve. This study also showed the absence of sensory amplitude in both the left median and left ulnar nerves. Therefore, the patient was diagnosed with IMN. Proximalization of the arterial inflow surgery was performed to redistribute blood flow while maintaining the AVF. The patient’s neurological symptoms resolved postoperatively. Various conditions can cause hand pain after AVF surgery; however, IMN has rarely been reported. A multidisciplinary approach is needed to avoid this rare complication in patients presenting with hand pain after AVF surgery.
Original article
Physical therapy, Sports Therapy, and Rehabilitation
Background Physiatrists are facing with survivors from disasters in both the acute and chronic phases of muscle and nerve injuries. Similar to many other clinical conditions, neuromusculoskeletal ultrasound can play a key role in the management of such cases (with various muscle/nerve injuries) as well. Accordingly, in this article, a recent single-center experience after the Turkey-Syria earthquake will be rendered.
Methods Ultrasound examinations were performed for various nerve/muscle lesions in 52 earthquake victims referred from different cities. Demographic features, type of injuries, and applied treatment procedures as well as detailed ultrasonographic findings are illustrated.
Results Of the 52 patients, 19 had incomplete peripheral nerve lesions of the brachial plexus (n=4), lumbosacral plexus (n=1), and upper and lower limbs (n=14).
Conclusion The ultrasonographic approach during disaster relief is paramount as regards subacute and chronic phases of rehabilitation. Considering technological advances (e.g., portable machines), the use of on-site ultrasound examination in the (very) early phases of disaster response also needs to be on the agenda of medical personnel.
An aging population and changes in dietary habits have increased the incidence of diabetes, resulting in complications such as diabetic foot ulcers (DFUs). DFUs can lead to serious disabilities, substantial reductions in patient quality of life, and high financial costs for society. By understanding the etiology and pathophysiology of DFUs, their occurrence can be prevented and managed more effectively. The pathophysiology of DFUs involves metabolic dysfunction, diabetic immunopathy, diabetic neuropathy, and angiopathy. The processes by which hyperglycemia causes peripheral nerve damage are related to adenosine triphosphate deficiency, the polyol pathway, oxidative stress, protein kinase C activity, and proinflammatory processes. In the context of hyperglycemia, the suppression of endothelial nitric oxide production leads to microcirculation atherosclerosis, heightened inflammation, and abnormal intimal growth. Diabetic neuropathy involves sensory, motor, and autonomic neuropathies. The interaction between these neuropathies forms a callus that leads to subcutaneous hemorrhage and skin ulcers. Hyperglycemia causes peripheral vascular changes that result in endothelial cell dysfunction and decreased vasodilator secretion, leading to ischemia. The interplay among these four preceding pathophysiological factors fosters the development and progression of infections in individuals with diabetes. Charcot neuroarthropathy is a chronic and progressive degenerative arthropathy characterized by heightened blood flow, increased calcium dissolution, and repeated minor trauma to insensate joints. Directly and comprehensively addressing the pathogenesis of DFUs could pave the way for the development of innovative treatment approaches with the potential to avoid the most serious complications, including major amputations.
Citations
Citations to this article as recorded by
Responsive to adaptive supramolecular hydrogels for diabetic wound treatment Shalini Balakrishnan, Revathy Remesh, Krishnan Kartha Kalathil, Anie Y Supramolecular Materials.2025; 4: 100081. CrossRef
Nanotechnology-enabled approaches for combating diabetic foot ulcer Padakanti Sandeep Chary, Anuradha Urati, Samia Shaikh, Rati Yadav, Valmala Bhavana, Naveen Rajana, Neelesh Kumar Mehra Journal of Drug Delivery Science and Technology.2025; 105: 106593. CrossRef
Natural products in the treatment of diabetic foot infection Mohsen Nazari, Leili Shokoohizadeh, Mohammad Taheri European Journal of Medical Research.2025;[Epub] CrossRef
Comprehensive review on diabetic foot ulcers and neuropathy: Treatment, prevention and management Kehkashan Parveen, Malik Asif Hussain, Sadaf Anwar, Halima Mustafa Elagib, Mohd Adnan Kausar World Journal of Diabetes.2025;[Epub] CrossRef
Enhanced therapy for diabetic neuropathy utilizing venlafaxine hydrochloride-loaded transferosome-based transdermal gel Kajol Patil, Pramod S. Salve, Ujban Md Hussain Hussain, Amol Tatode, Mohammad Qutub Nano Trends.2025; 9: 100085. CrossRef
Antioxidants improve the viability of diabetic bone marrow MSCs without rescuing their pro-regenerative secretome function Michelle Maartens, Mare Vlok, Mari van de Vyver Molecular and Cellular Endocrinology.2025; 601: 112519. CrossRef
Risk Factors Associated with Diabetic Foot Ulcers: A Multivariate Analysis Ajeet Saoji, Nitesh Upadhyay, Prachi Saoji, Kartik Khurana Biomedical and Biotechnology Research Journal.2025; 9(1): 67. CrossRef
Bacteriological profile of diabetic foot ulcers and analysis of serum meteorin levels Esra Erdogan, Azize Yetisgen, Lezzan Keskin, Elif Seren Tanriverdi, Isilay Gokce Benk Ugur Molecular Biology Reports.2025;[Epub] CrossRef
DFU-FuzzyLiteUNet: A lightweight u-net with Fuzzy sigmoid and lite transformer for diabetic foot ulcer segmentation Purwono Purwono, Yessica Nataliani, Hindriyanto Dwi Purnomo, Ivanna K. Timotius Biomedical Signal Processing and Control.2025; 108: 107902. CrossRef
Outcome of diabetic foot ulcers at a Tertiary Care Foot Centre in Pakistan Zahid Miyan, Arwa Hatim, Saniya Khakwani, Khalid Abdul Basit International Wound Journal.2025;[Epub] CrossRef
Diabetic Foot Ulcers: Pathophysiology, Immune Dysregulation, and Emerging Therapeutic Strategies John Dawi, Kevin Tumanyan, Kirakos Tomas, Yura Misakyan, Areg Gargaloyan, Edgar Gonzalez, Mary Hammi, Serly Tomas, Vishwanath Venketaraman Biomedicines.2025; 13(5): 1076. CrossRef
Adipose-derived Stem Cells for Treatment of Diabetic Foot Ulcers: A Review Prithiviraj Nagarajan, Rajalaksmi Prithiviraj, Sharangouda J. Patil, Suresh Babu Naidu Krishna, Vasanthrie Naidoo Current Stem Cell Research & Therapy.2025; 20(5): 509. CrossRef
The gel effect: Enhancing diabetic foot ulcer healing through hydrogel innovations Ghadeer Almarzooq, Ahmed Alaysereen, Zain Salman, Zahra Abdulrasool, Noor Jaragh, Sara Hasan, Omer Tarig, G. Roshan Deen BME Horizon.2025;[Epub] CrossRef
The combined impact of thymosin beta 4 and selenium on diabetic ulcers: a comprehensive review Karthikeyen Srinivasan, Rohith Sureshkumar, Jayshree Nellore, Bavanilatha Muthaiah, Johnson Retnara Samuel Selvan Christyraj, Valli Nachiyar Chandrasekaran Discover Biotechnology.2025;[Epub] CrossRef
Epigenetics and diabetic wound healing: Wilms tumor 1-associated protein as a therapeutic target Ashraf Al Madhoun World Journal of Diabetes.2025;[Epub] CrossRef
Synergistic Effect of Prolonged Oxygenation and Reactive Oxygen Species Scavenging on Diabetic Wound Healing Using an Injectable Thermoresponsive Hydrogel Jiyeon Lee, Jun Kim, Jisun kim, Soo‐Chang Song Small.2025;[Epub] CrossRef
Dysfunction of Microcirculation in Atherosclerosis: Implications of Nitric Oxide, Oxidative Stress, and Inflammation Marta Aleksandrowicz, Marek Konop, Mateusz Rybka, Łukasz Mazurek, Monika Stradczuk-Mazurek, Mateusz Kciuk, Bożena Bądzyńska, Leszek Dobrowolski, Marta Kuczeriszka International Journal of Molecular Sciences.2025; 26(13): 6467. CrossRef
Role of PPARγ, IL-1β Blockers, and TGF-β1 in Diabetic Wound Healing: Mechanisms and Therapeutic Potential Riani Erna, Arief S. Kartasasmita, Shanti F. Boesoirie, Wijana Hasansulama, Ramzi Amin Journal of Wound Management and Research.2025; 21(2): 58. CrossRef
Diabetic foot – prevention and control challenges Vitorino Modesto dos Santos, Taciana Arruda Modesto Sugai, Lister Arruda Modesto dos Santos Belize Journal of Medicine.2024;[Epub] CrossRef
Treatment of Morganella morganii-Associated Non-healing Diabetic Foot Ulcer With Vaporous Hyperoxia Therapy: A Case Report Afrah S Abedi, Jacob L McElroy, Vladimir Valencia, Rachel M Worcester, Zhi J Yu Cureus.2024;[Epub] CrossRef
Integrated genetic analysis of diabetic complications: Bioinformatics insights into foot ulcers, neuropathy and peripheral artery disease Jiaru Liang, Xiaoyang Gong, Xuyang Hu, Chong You, Jiaqi Zhou, Yuling Gao, Junwei Zong, Yong Liu International Wound Journal.2024;[Epub] CrossRef
Systematic review of translational insights: Neuromodulation in animal models for Diabetic Peripheral Neuropathy Rahul Mittal, Keelin McKenna, Grant Keith, Evan McKenna, Rahul Sinha, Joana R. N. Lemos, Khemraj Hirani, Mohammad Sarif Mohiuddin PLOS ONE.2024; 19(8): e0308556. CrossRef
Effect of Treatment of Neuropathic and Ischemic Diabetic Foot Ulcers with the Use of Local Ozone Therapy Procedures—An Observational Single Center Study Jarosław Pasek, Sebastian Szajkowski, Grzegorz Cieślar Clinics and Practice.2024; 14(5): 2139. CrossRef
High glucose combined with lipopolysaccharide stimulation inhibits cell proliferation and migration of human HaCaT keratinocytes by impacting redox homeostasis and activating the polyol pathway Zhenhui Xie, Shufan Zhou, Songtao Tang, Qiu Zhang, Lei Liu Molecular Biology Reports.2024;[Epub] CrossRef
Unveiling the challenges of diabetic foot infections: diagnosis, pathogenesis, treatment, and rehabilitation Chul Hyun Park Journal of Yeungnam Medical Science.2023; 40(4): 319. CrossRef
Case reports
Physical therapy, Sports Therapy, and Rehabilitation
Neurolymphomatosis (NL) is defined as the involvement of the peripheral nervous system in lymphocytic invasion. It is a very rare form of lymphoma that may occur as an initial presentation or recurrence. It affects various peripheral nervous structures and can therefore mimic disc-related nerve root pathology or compressive mononeuropathy. NL often occurs in malignant B-cell non-Hodgkin lymphomas. Notwithstanding its aggressiveness or intractability, NL should be discriminated from other neurologic complications of lymphoma. Herein, we present a case of primary NL as the initial presentation of diffuse large B-cell lymphoma (DLBCL) of the sciatic nerve. The patient presented with weakness and pain in his left leg but had no obvious lesion explaining the neurologic deficit on initial lumbosacral and knee magnetic resonance imaging (MRI). NL of the left sciatic nerve at the greater sciatic foramen was diagnosed based on subsequent hip MRI, electrodiagnostic test, positron emission tomography/computed tomography, and nerve biopsy findings. Leg weakness slightly improved after chemotherapy and radiotherapy. We report a case wherein NL, a rare cause of leg weakness, manifested as the initial presentation of primary DLBCL involving the sciatic nerve at the greater sciatic foramen.
Citations
Citations to this article as recorded by
FDG PET Detection of Neurolymphomatosis in Diffuse Large B-cell Lymphoma, With Neuropathy as Presenting Complaint Kersandra Begley, Richard Quinn Clinical Nuclear Medicine Open.2025;[Epub] CrossRef
Primary peripheral nerve lymphoma: a case report and literature review Di Wu, Hui Liu, Lingyu Hao, Xu Han, Sihan Wang, Yijia Xiang, Shizhu Yu, Yi Wang Neurological Sciences.2024; 45(4): 1447. CrossRef
A case report of surgical management of a solitary Non-Hodgkin's Lymphoma (NHL) arising from the proximal sciatic nerve Sivakumaran Gobinath, Ganeshamoorthy Sritharan, Subramaniam Bakeerathan, Paramanathan Shathana, Umesh Jayarajah International Journal of Surgery Case Reports.2023; 111: 108817. CrossRef
Hereditary neuropathy with liability to pressure palsy (HNPP) is a rare neurological genetic disease caused by deletion of the peripheral myelin protein 22 gene and presents in childhood or young adulthood. We report four cases of HNPP with typical and rare presentations, reflecting the broad clinical spectrum of this disease. Two patients presented with mononeuropathies that are frequently observed in HNPP; the remaining two presented with bilateral neuropathy or mononeuropathy anatomically present in the deep layer. This reflects the broad clinical presentation of HNPP, and clinicians should differentiate these conditions in young patients with monoparesis or bilateral paresis. Although HNPP is currently untreatable, early diagnosis in the emergency department can lead to early detection, eventually resulting in less provocation and recurrence which may cause early motor nerve degeneration.
Citations
Citations to this article as recorded by
Literature review of clinical analysis of hereditary neuropathy with liability to pressure palsies Limin Chen, Hongbo Zhang, Chunnv Li, Nuo Yang, Jiangtao Wang, Jianmin Liang Journal of Neurology.2025;[Epub] CrossRef
A 30-year-old male patient who experienced recurring weakness in bilateral upper and lower extremities: a clinical vignette Soo Hyun Ahn, Mathieu Boudier-Revéret, Seoyon Yang, Min Cheol Chang Journal of Yeungnam Medical Science.2025; 42: 27. CrossRef
The most cases with orbital metastases have been reported in patients with a prior established diagnosis of cancer and widespread systemic involvement. However, ocular symptoms can be developed as an initial presentation of cancer in patients without cancer history. We report a case of rapid progression from trochlear nerve palsy to orbital apex syndrome as an initial presentation of advanced gastric cancer.
Citations
Citations to this article as recorded by
Neoplastic nerve lesions Deep K. Patel, Kelly G. Gwathmey Neurological Sciences.2022; 43(5): 3019. CrossRef
The two distinctive clinical features of varicella-zoster virus (VZV) are varicella (chickenpox) by primary infection and zoster (singles) by the reactivation of latent infection. In addition to the two typical clinical symptoms mentioned above, diverse clinical manifestations have been reported as a result of VZV reactivation, including chronic radicular pain without rash, visual loss, facial palsy, dysphagia, sore throat, odynophagia, otalgia, hearing loss, dizziness, headache, hemiplegia, etc. Most of these symptoms are derived from neuropathy and vasculopathy of affected nerves and arteries. Diagnosis of VZV disease can be difficult if there is no appearance of a skin rash during development of atypical symptoms. In addition to natural infection, vaccination and anti-viral agent treatment have influenced the changes of epidemics and clinical presentations of varicella and zoster. In this article, diverse clinical manifestations caused by VZV reactivation, particular without skin rash, are reviewed.
Leber's hereditary optic neuropathy(LHON) is an optic nerve disease that causes blindness and is associated with maternally inherited mitochondrial DNA(mt DNA) mutations. The most common mitochondrial DNA mutation among LHON patients is a point mutation at the nucleotide 11778 in the subunit 4 of complex I. In one 45-year old male LHON patient with bilateral optic neuropathy, we investigated the presence of a point mutation of mitochondrial DNA and identified a single guanine to adenine transition mutation in the mitochondrial DNA at nucleotide point 11778.