Neurologic manifestations/comp/ictions of systemic scleroderma have received less attention in the literature than cardiac, pulmonary or gastrointestinal manifestations. We describe briefly three autopsied and proven cases of progressive systemic sclerosis in which there had developed prominent neurologic symptoms and signs, and discuss the relationship of those symptoms and signs with progressive systemic sclerosis. A review of neurologic complications is presented specifically to direct the attention of physicians to such symptoms which may later result in increased reporting of neurologic symptoms and signs. Already there is increased awareness due to reports of conditions such as trigeminal neuropathy and myopathy in more recent years. Cerebral, and specifically cerebrovascular, manifestations may be recognized more frequently in the future. A brief note of etiopathology and treatment is also mentioned.
Diabetic neuropathies are classified, for the sake of convenience, into four groups. First are the distal symmetrical variety that may be predominantly motor or predominantly sensory. Second are the rnononeuropathy syndromes of cranial or somatic nerves. Third are the automatic group and finally, any combinaLion of two or three varieLies. Etiopathology of these neuropathic syndromes takes into consideration the biochemical alterations and ischemic changes. The most recent understanding of the role of a/dose reductase in the polyol pathway is presented briefly, as is, in the hyperglycemic slate, sorbitol accumulation, which resuls in the decrease of AT-Pase activity and slowing of nerve conduction. In the treatment of diabetic neuropathies, a/dose reductase inhibitors are being used in many centers and their release for general use is anxiously awaited.
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