Nerve conduction impairment in patients with respiratory insufficiency and severe chronic hypoxemia
Narayan, M.; Ferranti, R.
Archives of Physical Medicine and Rehabilitation 59(4): 188-192
1978
ISSN/ISBN: 0003-9993 PMID: 646609 Document Number: 136851
Sensory median, ulnar and motor median, ulnar, peroneal and tibial nerve conduction velocities were determined in 16 patients with chronic respiratory insufficiency and severe hypoxemia. When conduction values were compared with closely matched controls, slowing of nerve conduction was seen in all the nerves in 13% of the patients. In about 25% of the patients, both upper extremity nerves were involved; in about 60% of the patients both lower extremity nerves were involved. In about 90% of the patients one or more motor nerves were affected. Statistically significant slowing was seen in all of the nerves except the sensory ulnar nerve. Clinical correlation of peripheral neuropathy was noted in about 80% of the patients. Prior to the study, all known causes of peripheral neuropathy were excluded; consequently other factors were looked into to explain peripheral neuropathy. Relative carboxyhemoglobinemia in smoking patients, blood pH and CO2 were considered, but they did not appear to be significant. Chronic severe hypoxemia seen in all of the patients was believed to be the likely influencing causative factor, since there is ample experimental and indirect clinical evidence to demonstrate an anoxic effect on peripheral nerve fibers.