As part of the workup of polyneuropathy, neurologists often encounter patients with paraproteinemias, also called monoclonal gammopathies. Given the relatively rising prevalence of both polyneuropathy and paraproteinemias in our aging population, this coexistence is frequently due to chance. Still, certain types of paraproteinemias have a well-defined causal role in the development of polyneuropathy, and therefore has implications in their subsequent work-up and management. Once a monoclonal gammopathy has been deemed as “benign” or of undetermined significance, looking at the heavy chain subtype is paramount in deciding whether it is related to a polyneuropathy. Conversely, polyneuropathies associated with monoclonal gammopathies tend to have a distinct clinical, serological, and/or electrodiagnostic phenotype that helps in establishing an association. Recognizing this association will determine approp riate workup and management.
Neuropatía
Alteraciones del reflejo H, reflejo de parpadeo y neuroconducción en pacientes alcohólicos crónicos.
Introduction: The objective of this study was to determine alterations of the Blink-reflex (BR), H-reflex (HR) and nerve-conduction in a group of alcoholic patients. Methods: A cross-sectional study was carried out on 21 alcoholic patients with an average age of 43.5 years. The history of alcohol abuse was 22 ± 7.4 years. At the time of the study, none of the patients had ingested alcohol for more than 30 days. Results: BR component alterations were as follows: R1 right 19.0%, R2 right 57.1%, R2 right contralateral 71.4%, R1 left 9.5%, R2 left 61.9% y R2 left contralateral 52.4%. Only the R2 right and left ipsi and contralateral latancies were significantly prolonged (P < 0.05). The H-reflex was absent in 90.5% of the patients. There was no significant difference in the comparison of sensitive or motor nerve-conduction speed between alcoholics and healthy subjects. Conclusions: The absence of H-reflex was the most frequently found electrophysiological alteration in this group of alcoholic individuals.
