• Title/Summary/Keyword: Electrophysiological

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근위축성 측삭경화증의 진단에 있어서 전기진단학적 검사 (Electrophysiological Studies in the Diagnosis of Amyotrophic Lateral Sclerosis)

  • 이동국
    • Annals of Clinical Neurophysiology
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    • 제6권1호
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    • pp.1-13
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    • 2004
  • Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disorder that primarily affects motor neurons. The characteristic features of this devastating disorder are the simultaneous presence of upper and lower motor neuron (LMN) signs with progression from one region of the neuraxis to the next and eventual death, typically from respiratory compromise. Electrophysiological studies are an indispensible part of the ALS evaluation, especially serving as an extension of the clinical examination, and most useful in identifying LMN dysfunction. Not only may electrodiagnostic studies reveal characteristic changes in those regions clinically manifesting signs, but it also serves to disclose asymptomatic areas of involvement.

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Pharmacological and electrophysiological characterization of rat P2X currents

  • Li, Hai-Ying;Oh, Seog-Bae;Kim, Joong-Soo
    • International Journal of Oral Biology
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    • 제33권1호
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    • pp.1-5
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    • 2008
  • Adenosine 5'-triphosphate (ATP) is an important extracellular signaling molecule which is involved in a variety of physiological responses in many different tissues and cell types, by acting at P2 receptors, either ionotropic (P2X) or G protein-coupled metabotropic receptors (P2Y). P2X receptors have seven isoforms designated as $P2X_{1^-}P2X_7$. In this study, we investigated the electrophysiological and pharmacological properties of rat $P2X_{1^-}P2X_4$ currents by using whole-cell patch clamp technique in a heterologous expression system. When ATP-induced currents were analyzed in human embryonic kidney (HEK293) cells following transient transfection of rat $P2X_{1^-}P2X_4$, the currents showed different pharmacological and electrophysiological properties. ATP evoked inward currents with fast activation and fast desensitization in $P2X_{^1-}$ or $P2X_{3^-}$ expressing HEK293 cells, but in $P2X_{2^-}$ or $P2X_{4^-}$ expressing HEK293 cells, ATP evoked inward currents with slow activation and slow desensitization. While PPADS and suramin inhibited $P2X_2$ or $P2X_3$ receptor-mediated currents, they had little effects on $P2X_4$ receptor-mediated currents. Ivermectin potentiated and prolonged $P2X_4$ receptor-mediated currents, but did not affect $P2X_2$ or $P2X_3$ receptor-mediated currents. We suggest that distinct pharmacological and electrophysiological properties among P2X receptor subtypes would be a useful tool to determine expression patterns of P2X receptors in the nervous system including trigeminal sensory neurons and microglia.

이상운동 질환에서의 신경생리적 검사법의 유용성 (Usefulness of Electrophysiological Tests in Movement Disorders)

  • 서만욱;이광우
    • Annals of Clinical Neurophysiology
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    • 제1권2호
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    • pp.126-146
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    • 1999
  • In clinical neurology various different electrophysiological tests are widely used to demonstrate the unsuspected malfunctioning in the nervous system and to monitor over time the clinical status of patients. In addition clinical neurologists and neurosurgeons take advantage of the intraoperative monitorings to increase the quality of neurosurgical operations in the posterior fossa, in the spinal cord, or in visual pathways. In the field of movement disorders, elecrophysiolgical tests provide neurologists with making accurate differential diagnoses with useful therapeutic stratergies as well as with investigating the pathophysiological machanisms. By using the electromyographic tests it could be possible for us to evaluate the types of blephalospasm, the extent of hemifacial spasm, the level of myoclonus, and the prime muscles of torticollis etc. Sometimes the myographic guidance may be critical for choosing the exact injecting site of botulinum toxin. These several decades various electroencephalographic and evoked potential tests has been utilized in the electrophysiological laboratories to understand the basic pathophysiology of myoclonus, spasticity and other central motor dysfunctions. It could be one of the breakthroughs in the area of behavorial neurology that the brain function can be mapped by the spontaneous or evoked electrical activities of nervous system since the movement related potentials (MRPs) had been studies for several decades. Various reflex tests such as masseter reflex, blink reflex, click evoked vestibulocollic reflex, facial reflex, stretch reflex, flexor reflex, H-reflex, H-reflex recovery curve, vestibular inhibition of H-reflex, reciprocal inhibition, recurrent or Renshaw reflex, Ib inhibition, cutaneous reflex have been also used to understand normal or abnormal physiology in movement disorders. Polysomnography, posturography and gait studies are also applied in clinical neurology in association with with movement disorders which are useful in deciding the treatment regimen.

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특발성 발목터널 증후군에서 내측 발바닥 신경의 전기 생리학적 검사 (Electrophysiological Study of Medial Plantar Nerve in Idiopathic Tarsal Tunnel Syndrome)

  • 안재영;김병준
    • Annals of Clinical Neurophysiology
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    • 제8권2호
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    • pp.146-151
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    • 2006
  • Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the tibial nerve within fibrous tunnel on the medial side of the ankle. The most common cause of TTS is idiopathic. This is a retrospective study to define the electrophysiological characteristics of idiopathic TTS. Methods: We reviewed the medical and electrophysiological records of consecutive patients with foot sensory symptoms referred to electromyography laboratory. Inclusion of patients was based on clinical findings suggestive of TTS. Among them, patients with any other possible causes of sensory symptoms on the foot were excluded. Control data were obtained from 19 age-matched people with no sensory symptoms or signs. Routine motor and sensory nerve conduction study (NCS) including medial plantar nerve (MPN) using surface electrodes were performed. Result: Twenty one patients (13 women, 8 men, 9 unilateral, 12 bilateral) were enrolled to have idiopathic TTS (total 31 feet). Tinel's sign was positive in 16 feet (51.6%) of TTS and four feet (10.5%) in control group. The statistically significant electrophysiological parameter was difference of sensory conduction velocity (SCV) between sural nerve and MPN. Amplitude of sensory nerve action potential and SCV of MPN were not different significantly between idiopathic TTS feet and controls. Conclusion: Bilateral development in idiopathic TTS was more common. Tinel's sign and difference of SCV between sural nerve and MPN may be helpful for the diagnosis of idiopathic TTS.

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이상감각과 통증을 호소하는 당뇨병 환자의 전기생리학적 특징 분석 (Electrophysiological Analysis in Diabetic Patients with Abnormal Sensation and Pain)

  • 양지원;이영배
    • 감성과학
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    • 제19권4호
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    • pp.111-118
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    • 2016
  • 당뇨병 환자들은 말초신경 손상의 합병증으로서 이상감각과 통증을 느낄 수 있는데 이는 날카로운 느낌, 차갑고 시린 느낌, 무딘 느낌, 살갗이 벗겨진 듯한 예민한 느낌, 화끈거리는 느낌, 따끔하고 가려운 느낌 등 다양하게 나타날 수 있다. 이를 진단하기 위해서 여러 선별검사와 전기생리학적 검사를 활용할 수 있다. 본 연구에서는 신경병통증척도와 미시간 신경병증 선별도구 및 신경전도검사를 통해 이상감감/통증을 호소하는 당뇨병 환자 11명과 호소하지 않는 당뇨병 환자 10명 간에 차이점 및 특징을 분석하였고, 세부 감각양상과 신경전도검사 지표간 상관성을 분석하였다. 그 결과 이상감각/통증을 호소하는 환자군에서 신경병통증척도와 미시간 신경병증 선별검사의 점수가 통계적으로 유의하게 높았고 신경전도검사에서는 주로 정중신경 운동신경과 비골신경이 의미 있는 기능 변화를 보였다. 세부 감각양상에 따른 신경전도검사 지표는 주로 정중신경 운동신경, 후경골신경, 장딴지신경에서 유의한 변화를 보였다. 이러한 결과들은 감각이상과 통증이 실제 말초신경 이상과 관련이 있음을 시사한다. 향후 많은 수의 대상자를 포함한 추가적인 연구가 필요하다.

Guillain-Barr$\acute{e}$ 증후군의 임상적 및 전기생리학적 연구 (Clinical and Electrophysiological Study on Guillain-Barr$\acute{e}$ Syndrome)

  • 윤성환;하정상;주성균;조용국;김정현;정지윤
    • Journal of Yeungnam Medical Science
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    • 제22권1호
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    • pp.52-61
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    • 2005
  • 1994년 1월부터 1999년 12월까지 6년간 영남대학교병원에 입원하여 G-B 증후군으로 진단 받은 45명의 환자를 대상으로 하여 그 임상적 양상과 신경생리학적 검사를 통한 특징을 분석 관찰하였다. 성별분포는 남자가 1.8:1로 많았고 연령은 10세 미만과 40대 연령군에서 높은 빈도를 나타내었으며 월별로는 다른 국내보고와는 달리 주로 12월과 2월 사이에 호발하였다. 선행질환은 30예 (66.7 %)에서 관찰되었고 그 중 상기도 질환이 19예로 가장 많았다. 발병당시의 임상양상은 심건반사 소실 또는 감소가 45예 (100 %), 사지 근력 약화가 38예(84.4 %)로서 두 가지 소견이 가장 많았다. 임상적 증상에 따른 정도의 차이에서는 경증이 많았으나 기관지 절개나 인공호흡이 필요하였던 경우도 10예 (22.2 %)를 보였고 입원 당시의 뇌척수액 단백세포해리 현상은 33예 (73.3 %)에서 관찰되었다. 그리고 시행된 치료로는 면역 글로불린 정맥주사가 29 예(64.4 %), 대증요법이 12예 (26.7 %)였다. 전기생리학적 진단기준 척도들 중 복합근활동전위의 진폭은 다른 기준척도에 비해 가장 초기에 현저한 변화를 보였으며, 병의 경과 중 발병 후 2~4주에 대부분의 전기생리적 기준척도가 최대 이상소견을 보였다. 그리고 임상증상과 신경생리학적 검사소견을 통한 분류에서 고전형 외에 Fisher 증후군과 축삭형을 보인경우는 각각 3예 (6.7 %)였다. 이 연구에서 G-B 증후군의 임상증상과 신경생리학적 특징은 다른 국내외 연구의 보고와 큰 차이는 없었으나 겨울철에 발생율이 높았던 점이 다른 차이였다. 그 이유에 대해서는 향후 광범위한 역학조사가 필요할 것으로 본다.

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Secondary Neurulation Defects-1 : Retained Medullary Cord

  • Kim, Kyung Hyun;Lee, Ji Yeoun;Wang, Kyu-Chang
    • Journal of Korean Neurosurgical Society
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    • 제63권3호
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    • pp.314-320
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    • 2020
  • Retained medullary cord (RMC) is a relatively recent term. Pang et al. newly defined the RMC as a late arrest of secondary neurulation leaving a non-functional vestigial portion at the tip of the conus medullaris. RMC, which belongs to the category of closed spinal dysraphism, is a cord-like structure that is elongated from the conus toward the cul-de-sac. Because intraoperative electrophysiological confirmation of a non-functional conus is essential for the diagnosis of RMC, only a tentative or an assumptive diagnosis is possible before surgery or in cases of limited surgical exposure. We suggest the term 'possible RMC' for these cases. An RMC may cause tethered cord syndrome and thus requires surgery. This article reviews the literature to elucidate the pathoembryogenesis, clinical significance and treatment of RMCs.

근전도상 근긴장증이 관찰되는 콜치신에 의한 근병증 1예 (Colchicine Induced Myopathy Presenting Electrophysiologic Myotonia)

  • 양지원;김나래;박기형
    • Annals of Clinical Neurophysiology
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    • 제11권2호
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    • pp.67-70
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    • 2009
  • Colchicine is widely used in the treatment of gouty arthritis, and chronic use of colchicine can cause vacuolar myopathy. We report colchicine-induced myopathy with electrophysiological myotonia in a patient with gouty arthritis. A 86-year-old man with gouty arthritis presented with progressive proximal weakness and gait disturbance. Electrophysiological finding showed myotonic myopathy and muscle biopsy revealed a vacuolar myopathy. His symptoms soon resolved with the discontinuation of colchicine.

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Electrophysiological and radiological evidence for the multifocal nature of a case of multifocal acquired demyelinating sensory and motor neuropathy

  • Seong, Gi-Hun;Bae, Jong Seok;Ryu, Sanghyo
    • Annals of Clinical Neurophysiology
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    • 제20권2호
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    • pp.101-104
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    • 2018
  • Multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy is a variant of chronic acquired demyelinating polyneuropathy. A 65-year-old women presented with upper arm weakness. A nerve conduction study showed conduction blocks over intermediate segments with sparing of distal compound action potentials. Magnetic resonance imaging revealed asymmetric hypertrophy of the brachial plexus on the affected side. These findings represent important electrophysiological and radiological evidence of MADSAM neuropathy. The condition of the patient began to improve after starting intravenous immunoglobulin administration.

Effects of Dopamine Agonists on Primary Cultured Neurons from Various Brain Regions

  • Kim, Kyeong-Man
    • Biomolecules & Therapeutics
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    • 제2권1호
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    • pp.16-22
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    • 1994
  • Using 2 to 4 day-old postnatal rats, primary brain cell cultures were made from various brain regions (substantia nigra, hippocampus, striatum, and nucleus accumbens). Whole-cell patch clamp technique was used for electrophysiological studies. Neurons cultured from substantia nigra were characterized more in detail to test whether these cultured neurons were appropriate for physiological studies. Immunocytochemical and electrophysiological properties of these cultured neurons agreed with those from other in vivo or in vitro studies suggesting that cultured neurons maintained normal cytological and physiological conditions. Modulation of ionic channels through dopamine receptors were studied from brain areas where dopamine plays important roles on brain functions. When neurons were clamped near resting membrane potential (-74mV), R(+), R(+)-SKF 38393, a specific D$_1$receptor agonist, activated cultured striatal neurons, and dopamine itself produced biphasic responses. Responses of cultured hippocampal neurons to dopamine agonists were kinds of mirror images to those from striatal neurons; D$_1$receptor agonists inhibited hippocampal neurons but quinpirole, a D$_2$receptor agonist, activated them. Neurons cultured from nucleus accumbens were inhibited by dopamine.

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