| Neurological manifestations in chronic mountain sickness: the burning feet-burning hands syndrome. | |
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MedLine Citation:
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PMID: 10990502 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To characterise the clinical features and nerve biopsy findings in patients with chronic mountain sickness (CMS) living in the Peruvian Andes, with particular attention to the occurrence of the "burning feet-burning hands" syndrome. METHODS: Symptoms and signs were documented clinically in 10 patients with CMS and compared with those in five healthy subjects all living at 4338 metres altitude. Sural nerve biopsies were obtained from three patients with CMS. The nerve fibre population and endoneurial microvessels were analyzed morphometrically. RESULTS: All patients with CMS experienced burning and tingling paraesthesiae in the distal parts of their limbs. Similar but milder symptoms confined to the feet occurred in four of five controls. Three patients with CMS had a mild sensory neuropathy on examination, controls were clinically normal. Nerve biopsies showed a mild demyelinating neuropathy in all three with a reduction in the unmyelinated axon population in one. The endoneurial blood vessels showed a reduced thickness in the basal laminal zone compared with control values but were otherwise normal. CONCLUSIONS: Apart from well recognised symptoms and signs of CMS, the study has shown that such patients may also exhibit a mild sensory neuropathy. Its relation to the burning feet-burning hands syndrome, which was not confined to the patients but was also found in controls at altitude, is uncertain. The time course and pattern of the centrifugal resolution of the burning paraesthesiae complex on low altitude sojourn of high altitude natives raises the possibility that a mechanism involving altered axonal transport may be involved. The reduced thickness of the basal laminal zone of microvessels implies that adaptive structural changes to hypobaric hypoxia may also occur in peripheral nerve and are similar to those reported in other tissues of high altitude natives. |
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Authors:
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P K Thomas; R H King; S F Feng; J R Muddle; J M Workman; J Gamboa; R Tapia; M Vargas; O Appenzeller |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Journal of neurology, neurosurgery, and psychiatry Volume: 69 ISSN: 0022-3050 ISO Abbreviation: J. Neurol. Neurosurg. Psychiatr. Publication Date: 2000 Oct |
Date Detail:
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Created Date: 2000-10-06 Completed Date: 2000-11-02 Revised Date: 2010-09-14 |
Medline Journal Info:
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Nlm Unique ID: 2985191R Medline TA: J Neurol Neurosurg Psychiatry Country: ENGLAND |
Other Details:
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Languages: eng Pagination: 447-52 Citation Subset: IM |
Affiliation:
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University Department of Clinical Neurology, Institute of Neurology, London WC1N 3BG, UK. pkt.hotline@virgin.net |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Altitude Sickness / pathology*, physiopathology Chronic Disease Female Humans Male Microscopy, Electron Middle Aged Peripheral Nervous System Diseases / pathology, physiopathology Sural Nerve / pathology*, physiopathology |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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