Glove or short sock style superficial and deep sensory disturbances

Introduction Gloves or short-socks, shallow and deep sensory disturbances are one of the symptoms of cancerous neuromuscular disease. They transmit deep-feeling nerve fibers or brain-sensing central lesions, and muscle and joint position, movement, and vibration disturbances come from muscles. Proprioception of tendons, periosteum, and joints, such as motion, position, and vibration. Cortical sensation (complex sensation): including locating sensation, two-point discrimination, graphic sensation and solid sensation. The cause is not clear and may be related to the immune response caused by autoimmunity or cancer.

Cause

The pathogenesis has not been fully elucidated. It is thought that its pathogenesis is not related to cancer toxins, infections, metabolic disorders and dystrophies, and may be related to immune responses caused by autoimmunity or cancer. There is no fixed relationship between the course of neuromuscular disease and cancer. The severity of neuromuscular disease is not parallel with the size and growth rate of cancer. Some symptoms can appear before the onset of cancer symptoms, and even seek medical treatment with neuromuscular symptoms, and cancer is found through systematic examination. Common in lung cancer, followed by breast cancer. Other digestive tract cancer, cervical cancer, rectal cancer, prostate cancer, lymphoma, multiple myeloma, etc. can also be seen.

an examination

Related inspection

CT examination cerebrospinal fluid examination - chemical examination - protein examination position perception pain cerebrospinal fluid routine test (CSF)

Different degrees of numbness, pain, or abnormal sensation at the distal end of the extremities. Gradually proceed and develop to the near end, with a shallow, deep sensory barrier in gloves or short socks. Cancerous peripheral neuropathy is differentiated from peripheral neuritis caused by various causes and peripheral neuropathy caused by anticancer drugs; muscle changes should be differentiated from myasthenia gravis, non-cancerous polymyositis and dermatomyositis; Identification with motor neuron disease, acute transverse myelitis; differentiation from other encephalopathy.

1. Examination of the skull base, CT and MRI.

2. Cerebrospinal fluid examination.

3. Chest, ECG, ultrasound.

Differential diagnosis

1. Segmental dissociative sensory disturbance: Syringomyelia is often characterized by segmental dissociative sensory disturbance. Due to a variety of reasons, a tubular cavity is formed in the spinal cord, called syringomyelia, and there is often gliosis around the cavity. The incidence of this disease is relatively slow, the clinical manifestations of the affected spinal cord segmental nerve damage symptoms, characterized by pain, temperature loss and disappearance, and deep sensory preservation of the sensory disturbance, combined with dyskinesia and nerve damage Nutritional disorders.

2. Partial blindness and sensory impairment: "Stroke" is a general term for a type of disease. The onset of such diseases is sudden, and it is characterized by sudden fainting on the ground, unconsciousness, or sudden occurrence of squinting, unfavorable language, and half-length. Stroke "three-biased" disease refers to a group of symptoms of contralateral hemiplegia, partial sensory disturbance and hemianopia. It is the main sign of lesions in the internal capsule and is more common in hemorrhagic stroke.

(1) Hemiplegia: refers to the patient's half-side voluntary movement disorder. The nerve fibers that govern free movement are called pyramidal bundles. The bundle is a fiber that is emitted from a large pyramidal cell in the anterior cerebral cortex, and descends through the inner capsule to the lower end of the medulla, to the corresponding spinal anterior horn cells, and then fibers from the anterior horn to innervate the skeletal muscle. If the internal capsule is bleeding, the damaged pyramidal beam is above the intersection plane, so the sputum occurs on the opposite side of the lesion, and the lateral side, the tongue and the limb are paralyzed.

(2) Partial sensory disturbance: refers to pain, temperature and proprioception in the half of the patient. The nerve fibers of the conduction painful party from the skin receptor to the nerve endings to the posterior horn of the afferent spinal cord, crossed to the contralateral lateral cord, and then passed through the inner capsule to the center of the cerebral cortex and then returned to the sensory center. The sensory center makes a comprehensive analysis of the incoming stimuli to make a judgment that is hot, cold, or painful. If the internal part is damaged, the contralateral side pain is transmitted and the temperature is disturbed. The receptors that transmit the proprioceptive sensation are stimulated and then afferent into the spinal cord and then lifted up to the medullary wedge nucleus and the thin bundle nucleus, and then the nerve fibers from the two nucleus intersect to the contralateral superior sac to the central posterior gyrus. If the internal capsule is damaged, the conduction of the sense of the partial body is interrupted, and the proprioception is lost such as loss of position.

(3) hemianopia: one side of the beam and the radioactive nerve fibers, the nerve fibers from the ipsilateral retina, through the internal capsule to the momentary visual center, reflecting the contralateral field of view. If the internal capsule is damaged and the radiation is damaged, the contralateral field is blunt.

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