The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, Dr. Sandrine Larue, Dr. Rami Massie and and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Acute
Acute conditions are sudden in onset.
AIDP – GBS -Guillain Barré Syndrome
is an inflammatory disorder of the peripheral nerves, those outside the brain and spinal cord. Rapid onset of weakness and often paralysis of the legs and arms within a few weeks of onset accompany this disorder. Back pain or pain in the extremities as well as numbness and tingling can also be part of the initial presentation. Patients may require intensive care to monitor breathing and other body functions. Rehabilitation helps during the recovery phase, which can take months or even years. GBS can affect any person, at any age, of either gender, or any ethnic background.
The Names of GBS
GBS has several other names, including “acute inflammatory demyelinating polyneuropathy (AIDP)” (acute, for sudden onset; inflammatory, to indicate inflammation in the nerves; demyelinating, to indicate damage to the outer protective covering of the nerve called myelin sheath; polyneuropathy, a disorder involving many nerves, not just one); “acute inflammatory polyneuropathy;” “acute idiopathic polyneuritis” (inflammation of nerves, hence -“neuritis”; of many nerves; due to “idiopathic,” or unknown causes); “acute idiopathic polyradiculoneuritis; Landry’s ascending paralysis; “acute dysimmune polyneuropathy (dys- for abnormal, as explained below);” “French polio (reflective of the neurologists who first recognized it);” and “post-infectious neuropathy” (since many cases develop after [‘post’], an infection). Currently, however, this syndrome is most commonly referred to as the “Guillain-Barré Syndrome,” or GBS.
AMSAN
AMSAN or Acute Motor and Sensory Axonal Neuropathy is a subtype of Guillain-Barré Syndrome, where the pathology lies in the axon itself (the electrical wire), rather than in the myelin (the insulating sheath around the nerves), which is the one affected in AIDP. This explains why it is often more severe and takes longer to recover compared to AIDP. It is often preceded by a diarrheal illness caused by the bacteria called Campylobacter Jejunii and is more common in Eastern Asia than in Europe or North America.
AFOs
AFO stands for ankle foot orthosis. This kind of brace is usually made of plastic. Orthoses are named for the parts of the body they control. An orthosis provides correction, support, or protection to a part of the body. AFOs help mobility in those with foot drop that is not getting better.
Antibodies
Antibodies are proteins that your body makes to help you fight infections. Each antibody made by your body is slightly different, because it fits like a lock and key to every foreign substance (such as a piece of a virus or bacterium) that gets into your body. Over the course of your life your body makes thousands of different antibodies as you are exposed to different infectious organisms that your body considers to be “foreign”. Antibodies are also made in response to vaccinations.
Anti-MAG Peripheral Neuropathy
Myelin-associated glycoprotein or MAG is a key glycoprotein essential to maintaining a healthy peripheral nervous system. Anti-MAG peripheral neuropathy is a very rare disease, constituting perhaps 5% of CIDP-like disorders and occurs when the body’s own immune system develops antibodies against the MAG. The disorder is predominantly characterized by distal sensory loss in the extremities (hands and feet), a tingling sensation in the affected limbs, a mild to moderate tremor, and poor balance which can lead to difficulty walking.
Anti-Neurofascin Demyelinating Diseases
Anti-neurofascin demyelinating diseases (anti-NF diseases) refers to conditions that result from auto-antibodies against neurofascins, which can produce both central and peripheral demyelination. These antibodies act at a Nodes of Ranvier. Some cases of combined central and peripheral demyelination (CCPD) could be produced by them. Some cases of CIDP are produced by auto-antibodies against several neurofascin proteins present in the neurons. Four of them have been reported to produce disease: NF186, NF180, NF166 and NF155.
Ascending Weakness
Muscle weakness or loss of muscle function (paralysis) affects both sides of the body and the weakness starts in the legs and spreads to the arms. This is called ascending paralysis.
Atrophy
Muscle atrophy is the wasting (thinning) or loss of muscle tissue. The loss of muscle tissue leads to thinning of the muscle and can happen after disease or disuse. For example, when an arm is temporarily put in a cast after a bone fracture for the bone to heal in position. Many of the muscles in the casted arm lay unused for a period of time, and begin to waste away due to lack of normal activity. Muscle atrophy also happens in nerve diseases such as GBS, CIDP and other neuropathies and with diseases of muscle.
Autoimmune Disease
An autoimmune disease is a medical condition in which a person’s immune system mistakes “self”, one’s own body tissue, for “nonself” or a foreign organism and stimulates an inappropriate attack. Picture your body’s “army” attacking itself by accident while trying to protect it.
Autonomic Nerves
The part of the nervous system that controls muscles of internal organs (such as the heart, blood vessels, lungs, stomach, and intestines) and glands (such as salivary glands and sweat glands). Autonomic nerves carry signals to and from the internal organs to automatically regulate their activities such as heart rate, blood pressure and the feeling that you have to empty your bladder.
Axon
The long threadlike part of a nerve cell or the wire along which impulses are conducted from the cell body to other cells. An axon, or nerve fiber, is a long, slender projection of a nerve cell, or neuron, in vertebrates, that typically conducts electrical impulses known as away from the nerve cell body. This allows activation of the muscle in case of a motor axon.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Balance
Balance refers to an individual’s ability to maintain their line of gravity within their Base of support (BOS). It can also be described as the ability to maintain equilibrium, where equilibrium can be defined as any condition in which all acting forces are cancelled by each other resulting in a stable balanced system. People with neuropathy may have difficulty with balance because the nerves do not take the proprioceptive information (information from the joint about position in space) up to the brain.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Central Nerves
These are the nerves that transmit messages between two neurons in the central nervous system, in the brain or the spinal cord. They are often called tracts or bundles.
CIDP – Chronic Inflammatory Demyelinating Polyneuropathy
is an inflammatory disorder of the peripheral nerves. There is increasing weakness, numbness and tingling of the legs and arms that can develop over a period of a few months and symptoms can continue if untreated. It is caused by damage to the covering of the nerves, called myelin. If treated early and aggressively, therapies can limit the damage to the nerves and contribute to a better quality of life. Like GBS, CIDP can start at any age, and with either gender.
Chronic
In medicine, this refers to a disease that lasts a long time. A chronic condition is one that lasts 3 months or more. Chronic diseases are in contrast to those that are acute (abrupt and brief) or subacute (within the interval between acute and chronic).
CNTN1 – Contactin-1
is a neuronal membrane protein that functions as a cell adhesion molecule. It may play a role in the formation of axon connections in the developing nervous system. Antibodies to contactin, like anti-neurofascin antibodies, can produce a disease that resembles CIDP and act at the node of Ranvier
Corticosteroids
Corticosteroids are a class of steroid hormones that are produced naturally in the adrenal glands of vertebrates, and also analogues of these hormones are synthesized (made). Two main classes of corticosteroids, glucocorticoids and mineralocorticoids, are involved in a wide range of physiological processes, including stress response, immune response, and regulation of inflammation, carbohydrate metabolism, protein catabolism, blood electrolyte levels, and behavior. Corticosteroids (“steroids”) are anti-inflammatory medications that were used in the past to treat GBS patients and are still used to treat CIDP. This class of drugs consists of medicines such as cortisol, prednisone, prednisolone and methyl-prednisolone.
Cranial Nerves
Nerves that carry information back and forth from your brain to your eyes, mouth, ears and other parts of your head.
Contractures
A contracture is a condition of shortening and hardening of muscles, tendons, or other tissue, often leading to deformity and rigidity of joints. For example, GBS patients may develop shortening of the Achilles tendon and calf muscles, which interferes with the upward movement (dorsiflexion) of the foot and the ability to stand flat on the feet. Similar problems can occur with the forearm muscles and hand movements. To prevent shortening of tendons and muscles, it is important to maintain full range of the joints. Exercises can be given by a physical therapist, and should be performed several times a day. In addition, splints or braces may be placed around joints at risk for contractures to maintain the ankle and wrist in more functional or normal positions.
Cyclophosphamide
Cyclophosphamide is a medication that was initially developed as a chemotherapy drug (used in the treatment of cancer). It was discovered that it also has significant ability to suppress the immune system, and is effective for immune mediated neuromuscular diseases. It works by killing rapidly dividing cells such as antibody-producing B-cells, which in turn decreases antibody levels. This leads to significant improvements in people with autoimmune neuromuscular disorders. Side effects include nausea, vomiting, diarrhea and loss of appetite. Regular bloodwork is typically required for monitoring.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
DADS: Distal acquired demyelinating symmetric polyneuropathy
DADS is a subtype of CIDP (Chronic Inflammatory Demyelinating Polyneuropathy) characterized by very pronounced demyelination affecting the distal segments of nerves, farther out along the nerve. Therefore, these patients typically have pronounced distal symptoms. Antibodies to one of the proteins associated with myelin called anti-myelin associatedglycoprotein, or anti-MAG antibodies, are often identified in this disorder.
Decubitus Ulcers
People who have severe weakness, and are in a wheelchair or on long bed rest can be prone to breakdown of tissue, particularly over boney prominences. The skin breakdown is caused by constant pressure to an area that lessens blood flow to the area. The resulting ulcers are called bed sores or “decubitus ulcers.” It is important to reduce pressure on the area by repositioning and using supporting surfaces. Antibacterial drugs may be needed to treat infection of the area.
Delirium
Delirium is a sudden change in a person’s mental function, which includes confused thinking and reduced awareness of the environment. This results in a change in behavior or level of consciousness. This change often affects attention levels leading to poor memory and concentration. Delirium can be caused by metabolic changes (such as low sodium), infections, surgery, drugs and alcohol intoxication or withdrawal. Symptoms often fluctuate and may be worse at night.
Demyelination
A demyelinating disease is any condition that results in damage to the protective covering (myelin sheath) that surrounds nerve fibers. Myelin is like the insulation on electric wires. It helps messages move quickly, the way electricity flows from a power source. When the myelin sheath is damaged, nerve impulses slow or even stop, causing neurological problems.
Central nervous system and peripheral nervous system demyelinating disease are different, because the myelin in the CNS and PNS are made by different types of cells, and typically diseases affect either one or the other.
CNS demyelination: the insulation of the nerves (myelin) in the brain, eye nerves and spinal cord may be affected. Myelin in the CNS is made by cells called oligodendrocytes. Multiple sclerosis (MS) is the most common example. People with MS do not have problems with their peripheral nerves but the signal doesn’t get transmitted correctly between the brain or spinal cord and muscles, and upward from the sensory receptors back through the central nervous system.
Peripheral nervous system demyelinating disorders affect the myelin that covers peripheral nerves. This is made by Schwaan Cells. These disorders can be inherited (as in Charcot-Marie-Tooth Disease) or acquired (as in GBS or CIDP).
Diaphragm
The diaphragm is a dome-shaped muscle separating the thorax from the abdomen. It plays a major role in breathing, as its contraction increases the volume of the thorax during inhalation and so inflates the lungs. The strength of this important breathing muscle can be affected in disorders of nerve, neuromuscular junction or muscle, causing shortness of breath.
Distal Muscles
The distal muscles are those farther from the center of the body and include the muscles of the lower arms/hands and lower legs/feet. Conversely, the proximal muscles are the muscles closest to the center of the body such as the muscles of the shoulder, pelvis, and upper arms and legs.
Drop Foot
Foot drop, sometimes called drop foot, is a general term for difficulty lifting the front part of the foot up (dorsiflexion). If you have foot drop, the front of your foot might drag on the ground when you walk, or make a “slapping sound” as you walk. Foot drop isn’t a disease. Rather, foot drop is a sign of an underlying neurological, muscular or anatomical problem.
Disequilibrium
Sensation of being off balance that is mainly experienced when standing. The imbalance or unsteadiness usually develops from diminished sensory input from the proprioceptive, visual or vestibular systems like the inner ear. There may be a sensation of impending fall, or need to use a gait aid for walking.
Dysphagia
Difficulty swallowing — taking more time and effort to move food or liquid from the mouth to your stomach. People with neuromuscular problems typically have difficulty with strength and coordination of the muscle of the mouth or throat. People may cough or choke if the food goes “down the wrong pipe” – into the trachea rather than the esophagus. A swallowing assessment can be performed by an OT or speech therapist, or a modified barium swallow may provide further information about the degree of risk for aspiration related to dysphagia.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
EMG – Electromyography
“EMG” often refers to the full electrodiagnostic study, which includes two parts: 1) nerve conduction studies, and 2) the needle electrode examination of the muscle. This is a diagnostic procedure used to help detect neuromuscular abnormalities. The test can be mildly uncomfortable but is typically not painful. The second part is not always required.
During the NCS, mild electrical stimulation is applied over the skin to test the ability of the nerves to carry the electrical impulse to the recording discs over skin (for sensory nerves) or muscle (for motor nerves). The electromyography component of the test is a technique for evaluating and recording the electrical activity produced by skeletal muscles using a small needle inserted into the muscle during movement or nerve stimulation. EMG is performed by a specialist (Neurologist or Physiatrist) with special training and certification in neurophysiology, using an EMG machine, to produce a record called an electromyogram.
Evoked Potentials
Evoked potentials are used to measure the electrical activity in certain areas of the brain and spinal cord. Electrical activity is produced by stimulation of specific sensory nerve pathways. Evoked potentials test and record how quickly and completely the nerve signals reach the brain.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Facial Weakness
Facial weakness or paralysis can affect one or both sides of the face. Weakness or paralysis of the facial muscles may cause difficulty with eye closure, wrinkling the forehead, puffing out the cheeks, and pronunciation. Food may pocket in the cheeks. Facial weakness can be caused by a central nervous system conditions such as a stroke, or a peripheral nervous system problem such as Bell’s Palsy or GBS.
Fasciculation
Fasciculation is an involuntary firing of a single motor neuron and all its innervated muscle fibers. A brief, spontaneous contraction affecting a small number of muscle fibers, often causing a flicker of movement under the skin, or twitch. It can be a symptom of disease of the motor neurons, when associated with weakness and loss of muscle bulk. Many healthy people have “benign fasciculations”, which are increased by stress, caffeine and lack of sleep and can be associated with cramps.
Fatigue
A condition marked by extreme tiredness and inability to function due to lack of energy. Fatigue may be acute or chronic.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Gait
A gait is a pattern of limb movements made during locomotion. Human gaits are the various ways in which a human can move, either naturally or as a result of specialized training.
GBS – Guillain-Barré syndrome
GBS is a rare disorder where the body’s immune system damages nerve. The damage to the nerves causes muscle weakness and sometimes paralysis. While its cause is not fully understood, the syndrome often follows infection with a virus or bacteria.
GM1 – Gangliosidosis-1
Gangliosidosis-1 (GM-1) is a progressive neurological genetic disorder caused by the absence of a vital enzyme. It is one of over 50 genetically inherited disorders known as Lysosomal Storage Diseases. Antibody to GM-1 protein can be found in MMN patients.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Hammer Toes
Hammertoe and mallet toe are foot deformities that occur due to an imbalance in the muscles, tendons or ligaments that normally hold the toe straight.
Hematologist
A hematologist is a doctor who specializes in researching, diagnosing, treating, and preventing blood disorders and disorders of the lymphatic system (lymph nodes and vessels).
Hematology
Hematology is the study of blood and blood disorders. Hematologists and hematopathologists are highly trained healthcare providers who specialize in diseases of the blood and blood components. These include blood and bone marrow cells.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Ig
Immunoglobulin (Ig) or antibodies are obtained from blood or plasma from 1,000 or more healthy donors. After mixing them all together, a sophisticated manufacturing process separates out and purifies the critical antibodies to create the very valuable prescription product, known as Ig. As with all blood products, the highest standards are met in purifying Ig to ensure there are no infections passed on from donors.
Immune System
The immune system is a complex organ made up of many parts spread throughout the entire body designed to protect you from foreign, disease-causing organisms, such as bacteria or viruses. The body’s immune response against infections involves the development of antibodies, also called immunoglobulins. Picture them as an army that is constantly circulating through your body’s blood system always looking for foreign enemies and then attacking and destroying them before they can do your body any harm.
Immunotherapies
Immunotherapy or biological therapy is the treatment of disease by activating or suppressing the immune system. Immunotherapies designed to elicit or amplify an immune response are classified as activation immunotherapies, while immunotherapies that reduce or suppress are classified as suppression immunotherapies.
Immunoglobulins
Immunoglobulins or antibodies are part of your blood’s plasma that fight disease.
Intubation
The insertion of a plastic flexible breathing tube into the patient’s windpipe i.e. trachea. Tracheal intubation maintains an open airway and helps the patient to breathe.
IVIG
Intravenous immune globulin (“IVIG”) is a blood product that is composed of antibodies from thousands of healthy donors. IVIG is administered through a needle or tube inserted into a vein and is used to treat certain types of immune disorders.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Lumbar Puncture (LP) – Spinal Tap
The procedure of taking fluid from the spine i.e. spinal fluid in the lower back through a hollow needle. LP is usually done for diagnostic purposes and to administer certain drugs to the brain through the spinal fluid.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
MADSAM
Multifocal Acquired Demyelinating Sensory And Motor neuropathy (MADSAM), also known as Lewis-Sumner Syndrome is considered a variant of CIDP. It shares many features with CIDP but typically is asymmetric (more on one side than the other), more prominent in the arms, and multifocal (multiple specific areas affected) presentation compared to patients with CIDP.
MFS – MILLER FISHER SYNDROME
Miller Fisher Syndrome (MFS), also called Fisher’s syndrome, is a variant of GBS and affects the peripheral nerves in a particular distribution. Patients with MFS have gait imbalance/ unsteadiness and weakness of eye muscles causing double vision, visual blurring, or droopy eyelids. Symptoms typically progress rapidly, usually over days. The condition is named after Dr. C. Miller Fisher who described it in 1956 as a limited variant of ascending paralysis, Guillain-Barré Syndrome (GBS).
MMN – Multifocal Motor Neuropathy
is an inflammatory nerve disease similar to CIDP and GBS that affects the myelin sheath, or the insulation covering of motor nerves. It typically causes weakness of the upper limbs, however any nerve and muscle group can be affected. Unlike GBS or CIDP, patients do not have numbness as sensory nerves are not involved. The condition has a slow course over many years. Nerve testing shows “blocking” of the responses in the nerves to the muscles i.e. motor nerves. Sometimes, antibodies to a molecule called GM1-ganglioside are present in the serum and can help with the diagnosis.
Mononeuropathy
Mononeuropathy is usually the result of damage to a single nerve or nerve group by trauma, injury, local compression, infiltration, prolonged pressure, or inflammation.
MRI – Magnetic Resonance Imaging
A non-invasive imaging technology used to investigate anatomy and function of the body in both health and disease without the use of damaging ionizing radiation. It is often used for disease detection, diagnosis, and treatment monitoring. It is based on sophisticated technology that excites and detects changes in protons found in the water that makes up living tissues. It is one of the most advanced and sensitive imaging modalities.
Muscle Spasms
Muscle spasms (muscle cramps) are painful contractions and tightening of your muscles.
Muscle Wasting
Shrinking or loss of muscle bulk caused by disease or lack of use. Muscle wasting decreases strength and the ability to move.
Myelin Sheath
Myelin is an insulating layer, or sheath that is present around the nerves, including those in the brain and spinal cord. It is made up of protein and fatty substances. The myelin sheath allows electrical impulses to transmit very quickly and efficiently along the nerve cells. Loss of myelin (termed demyelination) causes disruption or slowing of nerve impulse transmission as seen in GBS, CIDP and MMN.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Neurofascia
Neurofascia (plural neurofascias) (anatomy) The interface between the nervous system and the fascia (of muscles and bones)
Nerve Conduction Study
A nerve conduction velocity (NCV) test, also called a nerve conduction study (NCS) — measures the transmission of electrical impulses through your nerve. NCV can identify the type and severity and distribution of nerve damage.
Neurology
the branch of medicine or biology that deals with the anatomy, functions, and organic disorders of nerves and the nervous system. A Neuromuscular Neurologist specializes in the diagnosis and management of the diseases of nerves and muscles.
Neurological Autoimmune Diseases
Neurological conditions that are caused by the patient’s own immune system attacking and damaging the brain, spinal cord or peripheral nerves, muscles or junction of the nerve and muscles (also called the neuromuscular junction).
Neurologist
Is a physician specializing in neurology and trained to investigate, or diagnose and treat neurological disorders. Neurologists treat a myriad of neurologic conditions, including stroke, seizures, movement disorders such as Parkinson’s disease, autoimmune neurologic disorders such as MS, headache disorders like migraine and dementias such as Alzheimer’s disease and diseases of the nerves and muscles. Neurologists may also be involved in clinical research, clinical trials, and basic or translational research. While neurology is a nonsurgical specialty, its corresponding surgical specialty is neurosurgery.
Neuropathic Pain
Neuropathic pain occurs due to damage to the nerves at any level of the nervous system—the peripheral nerves, the spinal cord and the brain.
Nervous Systems – Central and Peripheral
Together, the spinal cord and the brain are known as the central nervous system (CNS) while the nerves and muscles and their junction in the body comprise the peripheral nervous system (PNS). Some neurological diseases affect only the CNS i.e. Multiple Sclerosis while others affect the PNS i.e. GBS, CIDP.
Neuromuscular Disease
A neuromuscular disease is any disease that affects the peripheral nervous system (PNS) i.e. the muscles, nerves or neuromuscular junction. Most common symptoms of neuromuscular diseases are weakness, numbness, neuropathic pain, gait imbalance etc.
Neuromuscular Medicine
Neuromuscular Medicine is a subdiscipline of neurology or physical medicine and rehabilitation. It deals with the diseases that affect neurons, nerves, neuromuscular junction, and muscles.
Nodes of Ranvier
These are the gaps between the myelin sheath where the axons are left uncovered. Because the myelin sheath is largely composed of an insulating fatty substance, the nodes of Ranvier allow the generation of a fast electrical impulse along the axon.
NF155
Neurofascin-155 (NF155) is protein of paramount importance for the function of Nodes of Ranvier. Autoantibodies against NF155 disrupt the transmission of nerve impulses and have been identified in 5-10% of patients with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP).
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Occupational Therapy
A form of therapy for those recuperating from physical or mental illness that encourages rehabilitation through the performance of activities required in daily life.
Onset
In medicine, the first appearance of a sign or symptom of a disease is termed as the onset of illness.
Orthotist
An orthotist is a healthcare professional who makes and fits braces and splints (orthoses) for people who need added support for body parts that have been weakened by injury, disease, or disorders of the nerves, muscles, or bones. They work under a doctor’s orders to adapt braces or create custom-designed braces.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Paradoxical Breathing
In normal breathing chest wall expands (moves out) with inspiration and moves in with expiration. When this pattern is reversed i.e. chest wall moves in on inspiration and out on expiration it is called paradoxical breathing. It is a sign of respiratory distress associated with damage to the structures involved in breathing.
Paralysis
The loss of the ability to move (and sometimes to feel anything) of a part of the body. It typically as occurs in condition that affect the brain, spinal cord, nerves or muscles.
Paranodal Antibodies
Nodal/paranodal antibodies cause a specific subgroup of inflammatory peripheral neuropathies that present clinically with a prolonged subacute phase, sensory ataxia and tremor, and typically respond poorly to IV immunoglobulin (IVIG).
Paresthesia
Paresthesia refers to spontaneous or unprovoked pins and needles or prickling sensations that are usually felt in the extremities. It can also occur in other parts of the body. The sensation is usually painless and can be described as tingling, skin crawling, or itching.
Passive Physiotherapy
Passive physiotherapy is therapy that is performed on the client rather than by the client. It can include techniques like massage, acupressure, heat packs, and mobilisation and machines like ultrasounds, interferential, TENS, laser, and traction.
Peripheral Nerves
The part of the nervous system that is outside the central nervous system and comprises the cranial nerves excepting the optic nerve, the spinal nerves, and the autonomic nervous system.
A peripheral nerve connects the central nervous system to the peripheral end organ be it muscle, skin, or other organs. The peripheral nerve communicates to a muscle through a neuromuscular junction.
Peripheral Nervous System
The peripheral nervous system (PNS) is one of two components that make up the nervous system, with the other part being the central nervous system (CNS).
Peripheral Neuropathy
Peripheral neuropathy occurs when nerves are damaged or destroyed and can’t send messages from the brain and spinal cord to the muscles, skin and other parts of the body. Peripheral nerves go from the brain and spinal cord to the arms, hands, legs, and feet. When damage occurs, numbness and pain in these areas may occur. Peripheral neuropathy can affect multiple nerves (polyneuropathy) or only one nerve or nerve group (mononeuropathy) at a time.
Peripheral Neuropathy is not a single disease. It’s a general term for a series of disorders that result in damage to the body’s peripheral nervous system.
Plasma Exchange-Plasmapheresis
Plasma exchange, also known as plasmapheresis, is a way to “clean” or “filter” your blood. It works sort of like kidney dialysis. During the treatment, plasma — the liquid part of your blood — gets replaced with plasma from a donor or with a plasma substitute. This results in clearing out unwanted antibodies.
Physiatrist
Physical Medicine and Rehabilitation (PM&R) physicians, also known as physiatrists, treat a wide variety of medical conditions affecting the brain, spinal cord, nerves, bones, joints, ligaments, muscles, and tendons. Specifically, PM&R physicians focus treatment on restoring function.
Physiotherapist
Physical therapy, also known as physiotherapy, is one of the allied health professions. It is provided by physical therapists who promote, maintain, or restore health through physical examination, diagnosis, prognosis, patient education, physical intervention, rehabilitation, disease prevention, and health promotion.
Polyneuropathy
Is damage or disease affecting peripheral nerves in roughly the same areas on both sides of the body, featuring weakness, numbness, and burning pain. It usually begins in the hands and feet and may progress to the arms and legs and sometimes to other parts of the body. It may be acute or chronic. A number of different disorders may cause polyneuropathy, including diabetes and GBS.
Proximal Muscles
The proximal muscles are the muscles closest to the center of the body such as the muscles of the shoulder, pelvis, and upper arms and legs.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Reflexes
In biology, a reflex, or reflex action, is an involuntary, unplanned sequence or action and nearly instantaneous movement in response to a stimulus. A reflex is made possible by neural pathways called reflex arcs which can act on an impulse before that impulse reaches the brain. In neuromuscular diseases, assessment of deep tendon reflexes (DTRs) is a critical part of the neurological examination. DTRs are assessed by striking a hammer to a muscle tendon and looking at the reflex muscle contraction. Reduced or absent DTRs are the hallmark of a peripheral neuropathy like GBS.
Rehabilitation
Rehabilitation is defined as “a set of interventions designed to optimize functioning and reduce disability in individuals with health conditions in interaction with their environment”.
Residual
Something that remains to discomfort or disable a person after an illness, injury, operation, or the like.
Respiratory System
The respiratory system involves the structures stretching from the nasal and oral cavities to the lungs including the diaphragm and the accessory breathing muscles and their nerves.
Respiratory Therapist
A respiratory therapist (RT) is a certified medical professional who specializes in providing healthcare for your lungs.
Rituximab
Rituximab is a monoclonal antibody i.e. produced by a single clone of cells, and targets and kills antibody producing immune cells called B cells that carry a protein called CD20 on the surface. Rituximab is one of the most promising treatment options for certain autoimmune conditions, as it removes antibodies from the blood by cutting off their production at the source i.e. B cells. There is a risk that other infections and diseases could occur that would normally be prevented by an intact immune system. Usually Rituximab is not prescribed unless symptoms become severe.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Schwann Cells
Schwann cells are a variety of glial cells that keep peripheral nerve fibres (both myelinated and unmyelinated) alive. In myelinated axons, Schwann cells form the myelin sheath. The sheath is not continuous. Individual myelinating Schwann cells cover about 1 mm of an axon—equating to about 1000 Schwann cells along a 1-m length of the axon. The gaps between adjacent Schwann cells are called nodes of Ranvier.
SCIG – Sub-Q
SCIG is self-administered by subcutaneous immunoglobulin infusion (SCIG) in which you infuse IgG antibodies into the fatty tissue just below your skin. Patients are trained by a qualified healthcare professional on the correct method of self-infusion to ensure they are comfortable with the process before doing infusions at home. Patients are followed up on a regular basis to ensure continued patient competency.
Sensory Nerves
Depending on their function, nerves are known as sensory, motor, or mixed. Sensory nerves,
sometimes called afferent nerves carry information from the outside world, such as sensations of heat, cold, and pain, to the brain and spinal cord.
Motor nerves, or efferent nerves, transmit impulses from the brain and spinal cord to the
muscles. Mixed nerves are composed of both motor and sensory fibers, and transmit messages
in both directions simultaneously. Sensory nerves carry information from various parts of the body, such as from skin and joints, to the spinal cord and then up into the brain, where the signal is recognized as a particular sensation. Examples of these sensations include temperature, pain, hard versus soft textures and joint position, such as whether your elbow is bent or straight.
Subacute
Subacute means rather recent onset or somewhat rapid change generally between 4 and 8 weeks. In contrast, acute indicates sudden onset with rapid change and/or progression of neurologic deficits over less 4 weeks (i.e., AIDP), whereas chronic indicates slow progression over greater than 8 weeks (i.e., CIDP).
Symmetrical
Correspondence in size, shape, and relative position of parts on opposite sides of a dividing line or median plane or about a center or axis. Occurring on both sides of the body.
Syndrome
A syndrome (from the Greek word meaning ‘run together’) produces a number of symptoms without an identifiable cause. A syndrome refers to a group of symptoms and signs, while a disease refers to an established condition.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
TMJ
The temporomandibular joints (TMJ) are the 2 joints that connect your lower jaw to your skull. More specifically, they are the joints that slide and rotate in front of each ear, and consist of the mandible (the lower jaw) and the temporal bone (the side and base of the skull).
Tracheostomy
A tracheostomy is an opening created at the front of the neck so a tube can be inserted into the windpipe (trachea) to help you breathe. If necessary, the tube can be connected to an oxygen supply and a breathing machine called a ventilator. Tracheostomy is perfroemd in aptients who are unable to breath on their own and is usually a temporary measure: the opening may be allowed to gradually close if the patient’s breathing difficulties improve.
Tremor
A tremor is an involuntary rhythmic shaking movement in one or more parts of your body. Tremor occurs most often in your hands, but it could also affect your arms, head, vocal cords, trunk, and legs. There are many different types and causes of tremor. Some tremors occur in limbs at rest, for example in Parkinson’s disease. Most tremors occur during activities, such as in the condition called essential tremor, which can be partly genetic. Tremors can also occur in patients with neuropathy, both familial and sporadic.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Ventilation
The movement of air between the environment and the lungs via inhalation and exhalation.
Ventilator
The movement of air between the environment and the lungs via inhalation and exhalation.
A machine designed to move breathable air into and out of the lungs. Most patients with ventilators were typically admitted to intensive care units, thought home ventilators have become increasingly available.
The information provided in the Condition Glossary has been validated by:
Dr. Steven Baker, Dr. Pierre Bourque, Dr. Vera Bril, Dr. Kristine Chapman, and Dr. Zaeem Siddiqi.
( Members of our Medical Advisory Board )
Weakness
Weakness refers to a decrease in muscle strength. Fatigue is tiredness that may be either independent of, or associated with, exertion. Muscle fatigue is the key manifestation in myasthenia gravis. Weakness is a lack of physical or muscle strength and the feeling that extra effort is required to move your arms, legs, or other muscles.
Weaning
The term “weaning” can be used to describe the gradual process of reducing a treatment i.e. decreasing ventilator support, reducing a medication dose i.e. steroids. Weaning is more prudent than abrupt/sudden discontinuation of a therapy as it prevents a relapse of the clinical problem.