Abstract • Twenty of 23 patients with chronic obstructive pulmonary disease (COPD) showed electrophysiologic evidence of peripheral nerve dysfunction. Abnormalities of sensory nerve conduction were most common, affecting the sural nerve (20 subjects), ulnar nerve (11), radial nerve (eight), and median nerve (seven). Six subjects had impairment of both sensory and motor nerve function, with the common peroneal being the most frequently affected motor nerve. Clinical signs of neuropathy were found in four patients. Cigarette smoking, expressed as pack-years, was correlated significantly with the electrophysiologic abnormalities. These findings indicate that subclinical polyneuropathy commonly occurs in association with COPD and that this COPD-related neuropathy is correlated with cigarette consumption. From these data we suggest that a substance or substances in cigarette smoke, such as nicotine, taken on a long-term basis, may be toxic to peripheral nerves. References 1. Jennekins FGI: Peripheral neuropathies in diseases of internal organs . Neth J Med 1973;16:38-46. 2. Appenzeller O, Parks RD, MacGee J: Peripheral neuropathy in chronic diseases of the respiratory tract . Am J Med 1968;44:873-880.Crossref 3. Wilner EC, Brody JA: An evaluation of the remote effects of cancer on the nervous system . Neurology 1968;18:1120-1124.Crossref 4. Aminoff MJ: Electromyography in Clinical Practice . Menlo Park, Calif, Addison-Wesley, 1978, pp 110-161. 5. Gilliatt RW, Sears TA: Sensory action potentials in patients with peripheral nerve lesions . J Neurol Neurosurg Psychiatry 1958;21:109-118.Crossref 6. Downie AW, Scott TR: An improved technique for radial nerve conduction studies . J Neurol Neurosurg Psychiatry 1967;30:332-336.Crossref 7. DiBenedetto M: Sensory nerve conduction in lower extremities . Arch Phys Med Rehabil 1970;51:253-258. 8. Mayer RF: Nerve conduction studies in man . Neurology 1963;13:1021-1030.Crossref 9. Thomas PK, Sears TA, Gilliatt RW: The range of conduction velocity in normal motor nerve fibers to the small muscles of the hand and foot . J Neurol Neurosurg Psychiatry 1959;22:175-181.Crossref 10. Yap C-B, Hirota T: Sciatic nerve motor conduction velocity study . J Neurol Neurosurg Psychiatry 1967;30:233-239.Crossref 11. Trojaborg W: Motor nerve conduction velocities in normal subjects with particular reference to the conduction in proximal and distal segments of median and ulnar nerve . Electroencephalogr Clin Neurophysiol 1964;17:314-321.Crossref 12. Buchtal F, Rosenfalck A: Evoked action potentials and conduction velocity in human sensory nerves . Brain Res 1966;3:1-122. 13. Buchtal F: Electrophysiological abnormalities in metabolic neuropathies . Acta Neurol Scand 1970;46( (suppl 43) ):156-176. 14. Ball WC: Manifestations of pulmonary disease , in Harvey AM, Cluff LE, Johns RJ, et al (eds): The Principles and Practice of Medicine . New York, Appleton-Century-Crofts, 1968, pp 351-366. 15. Simpson LL, Curtis DR: Neuropoisons: Their Pathophysiological Actions . New York, Plenum Press, 1974, vol 2, pp 61-97.
Archives of Neurology – American Medical Association
Published: Oct 1, 1981