Neurology and Gout
Neurology and Gout basics
Gout is due to a disorder of uric acid metabolism.In this condition, uric acid crystals are deposited on the cartilage of joints, tendons and surrounding tissues due to high levels of uric acid in the blood. This triggers an inflammatory reaction of these tissues.
The classic picture is of severe, sudden, burning pain, swelling, redness, warmness and stiffness in the joint."
The inflammation of the tissues around the joint also causes the skin to be swollen, tender and sore if it is even slightly touched. For example, a blanket or even the lightest sheet draping over the affected area could cause extreme pain.Gout usually attacks the big toe , however it can also affect other joints such as the ankle, knee, wrist, elbow, fingers, and spine. Uric acid stones can form kidney stones or get deposited as "gouty tophi" in the outer ear in severe cases.
New research shows people with gout may have less chance of developing Parkinson's Disease
The following is an extract from the article "Gout and risk of Parkinson disease
: a prospective study." by Alonso A, Rodríguez LA, Logroscino G, Hernán MA. from the Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA. published in the journal "Neurology" 2007 Oct 23;69(17):1696-700. (Neurology and gout related article)
Several reports suggest that higher levels of serum uric acid are associated with a lower risk of Parkinson disease . None of these studies, however, evaluated the potential association between gout, a condition characterized by hyperuricemia, and the risk of Parkinson disease .
OBJECTIVE: To estimate prospectively the association between gout diagnosis and the risk of Parkinson disease .
METHODS: We conducted a case-control study nested in the General Practice Research Database, a computerized database that gathers information on more than 3 million Britons followed up by their general practitioners. Parkinson disease cases occurring between January 1995 and December 2001 were identified, and matched with up to 10 controls by sex, age, practice, and start of follow-up. We obtained information on history of gout and use of anti-gout medication using the computerized medical records.
RESULTS: During the study period, we identified 1,052 Parkinson disease cases and 6,634 controls. Individuals with previous history of gout had a lower risk of developing Parkinson disease (OR 0.69, 95% CI 0.48, 0.99). This association was evident among men (OR 0.60, 95% CI 0.40, 0.91) but not among women (OR 1.26, 95% CI 0.57, 2.81; p for interaction: 0.11). Initiation of anti-gout medication was associated with a lower risk of Parkinson disease (OR 0.57, 95% CI 0.19, 1.70).
CONCLUSION: Gout is associated with a lower risk of Parkinson disease . Our findings provide additional support for a potential link between uric acid and Parkinson disease . Further research is required to explore a potential effect modification by sex.
In other words, this novel link between neurology and gout may mean that gout actually has a positive aspect!
How may neurology and gout be related?
Gout may be related to the following neurological conditions:
Isolated neuropathies due to focal nerve compression
This may lead to sensory disturbances such as
numbness or tingling
Exercise intolerance and muscle cramps due to phosphofructokinase deficiencyPartial tear of rectus femoris muscle
Cord compression due to epidural deposits of gout tophi
Multiple Symmetric Lipomatosis (Madelung syndrome)
Familial progressive necrotizing encephalopathy
The features of the Lesch-Nyhan syndrome are mental retardation, a type of cerebral palsy with increased muscle tone, a movement disorder called choreoathetosis, uric acid urinary stones, and self-destructive biting of fingers and lips.
Drugs used in gout may have neurological side-effects
may increase the risk of muscle disease (myopathy) due to cholesterol lowering drugs
Colchicine may cause a symmetrical peripheral neuropathy with sensory problems starting in the fingers and toes
Allopurinol may cause a different kind of peripheral neuropathy called "vasculitic neuropathy" which is less symmetrical and may cause weakness and sensory problems.
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