Cochrane Db Syst Rev
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Idiopathic lumbosacral plexopathy (ILSP), also called lumbosacral plexitis or non-diabetic lumbosacral (radiculo)plexus neuropathy is a rare clinical entity. The core features are (sub)acute, severe, asymmetrical leg pain, followed by asymmetrical multifocal weakness and atrophy in the subsequent weeks or months. Sensory symptoms include paresthesias, hypesthesia, allodynia, and autonomic dysfunction. ILSP generally runs a monophasic and self limiting course. Recovery starts slowly over months to several years and is nearly always incomplete. Some studies suggest that the condition has an immune-mediated etiology. Biopsies of distal cutaneous nerve segments have shown features suggestive of an inflammatory microvasculitis causing ischemic damage of the nerves. The clinical and pathological findings are similar to those found in diabetic lumbosacral plexus neuropathy and suggest that inflammation may form part of the final common pathway in both conditions. ⋯ There is at present no evidence from randomized trials to support any recommendation on the use of any immunotherapy treatment in ILSP.
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Idiopathic lumbosacral plexopathy (ILSP), also called lumbosacral plexitis or non-diabetic lumbosacral (radiculo)plexus neuropathy is a rare clinical entity. The core features are (sub)acute, severe, asymmetrical leg pain, followed by asymmetrical multifocal weakness and atrophy in the subsequent weeks or months. Sensory symptoms include paresthesias, hypesthesia, allodynia, and autonomic dysfunction. ILSP generally runs a monophasic and self limiting course. Recovery starts slowly over months to several years and is nearly always incomplete. Some studies suggest that the condition has an immune-mediated etiology. Biopsies of distal cutaneous nerve segments have shown features suggestive of an inflammatory microvasculitis causing ischemic damage of the nerves. The clinical and pathological findings are similar to those found in diabetic lumbosacral plexus neuropathy and suggest that inflammation may form part of the final common pathway in both conditions. ⋯ There is at present no evidence from randomized trials to support any recommendation on the use of any immunotherapy treatment in ILSP.
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Cochrane Db Syst Rev · Dec 2013
Review Meta AnalysisIntravenous immunoglobulin for chronic inflammatory demyelinating polyradiculoneuropathy.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) causes progressive or relapsing weakness and numbness of the limbs, developing over at least two months. Uncontrolled studies suggest that intravenous immunoglobulin (IVIg) helps. This review was first published in 2002 and has since been updated, most recently in 2013. ⋯ The evidence from RCTs shows that IVIg improves disability for at least two to six weeks compared with placebo, with an NNTB of three. During this period it has similar efficacy to plasma exchange, oral prednisolone and intravenous methylprednisolone. In one large trial, the benefit of IVIg persisted for 24 and possibly 48 weeks. Further research is needed to compare the long-term benefits as well as side effects of IVIg with other treatments.
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Cochrane Db Syst Rev · Dec 2013
Review Meta AnalysisIntravenous immunoglobulin for chronic inflammatory demyelinating polyradiculoneuropathy.
Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) causes progressive or relapsing weakness and numbness of the limbs, developing over at least two months. Uncontrolled studies suggest that intravenous immunoglobulin (IVIg) helps. This review was first published in 2002 and has since been updated, most recently in 2013. ⋯ The evidence from RCTs shows that IVIg improves disability for at least two to six weeks compared with placebo, with an NNTB of three. During this period it has similar efficacy to plasma exchange, oral prednisolone and intravenous methylprednisolone. In one large trial, the benefit of IVIg persisted for 24 and possibly 48 weeks. Further research is needed to compare the long-term benefits as well as side effects of IVIg with other treatments.
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Cochrane Db Syst Rev · Dec 2013
ReviewPassive movements for the treatment and prevention of contractures.
Contractures, a common complication following immobility, lead to restricted joint range of motion. Passive movements (PMs) are widely used for the treatment and prevention of contractures; however, it is not clear whether they are effective. ⋯ It is not clear whether PMs are effective for the treatment and prevention of contractures.