• 제목/요약/키워드: Median nerve

검색결과 236건 처리시간 0.026초

Neuromodulation of the median nerve in carpal tunnel syndrome, a single-blind, randomized controlled study

  • Gevher Rabia Genc Perdecioglu;Mehlika Panpalli Ates;Damla Yuruk;Omer Taylan Akkaya
    • The Korean Journal of Pain
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    • 제37권1호
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    • pp.34-40
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    • 2024
  • Background: This study aimed to evaluate the efficacy of pulsed radiofrequency applied using transcutaneous electrodes in carpal tunnel syndrome (CTS). Methods: After randomization, the patients received two cycles of noninvasive pulsed radiofrequency (NiPRF), once weekly, or splinting (the control group) for three months. Clinical evaluations were recorded at baseline and weeks 4 and 8. The Boston Carpal Tunnel Syndrome Questionnaire (BCTQ) was used to determine the functional status and symptom severity. Results: Sixty-two patients were followed up for three months. There was no difference between the groups in the BCTQ scores before and after treatment. The NiPRF group found a significant difference between the BCTQ measurements at all time intervals (paired sample t-test; P < 0.001). In the splint group, there was a significant difference only between the basal-1st month and basal-3rd month (paired samples t-test; P < 0.001). The main effect of the time variable was statistically significant (ANOVA; P < 0.001), but the group variable was not. There was no correlation between the BCTQ results measured at any time and the electroneuromyelogragphy findings in either group. Conclusions: NiPRF effectively improves symptoms and functionality in patients with CTS for up to 3 months. Thus, NiPRF can be considered an easy, safe, and useful alternative treatment modality for CTS.

경근추나요법과 경피전기자극치료가 급성 요통 환자의 통증 및 척추기립근 경근전도에 미치는 영향 (The Impacts of Muscle Energy Technique (MET) and Transcutaneous Electrical Nerve Stimulation (TENS) Performed on Elector Spinae Muscle of Acute Low Back Pain Patients on Pain and Meridian Electromyography)

  • 김순중;박동수;정수현;안재민
    • 한방재활의학과학회지
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    • 제24권1호
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    • pp.83-92
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    • 2014
  • Objectives To evaluate the clinical usefulness between muscle energy techniques (MET) and transcutaneous electrical nerve stimulator (TENS), we performed both on elector spinae muscle of acute low back pain patients. Methods After performing MET and TENS, we compared both in terms of electrical activity. We performed MET or TENS on elector spinae muscle of acute low back pain patients in each group (n=15,15). After performing MET or TENS, we analyzed root mean square (RMS), median edge frequency (MEF) and asymmetry index (AI). Results 1. After performing MET on elector spinae muscle of acute low back pain patients, RMS was significantly decreased compared with before (p<0.005). 2. After performing TENS on elector spinae muscle of acute low back pain patients, RMS was significantly decreased compared with before (p<0.005). 3. After performing MET on elector spinae muscle of acute low back pain patients, asymmetric index was significantly decreased compared with before (p<0.05). Conclusions According to above results, performing MET on elector spinae muscle of acute low back pain patients has effect in terms of RMS and asymmetric index. And performing TENS on elector spinae muscle of acute low back pain patients also has similar effect in terms of RMS but has not in terms of asymmetric index.

Surgical Results of Selective Median Neurotomy for Wrist and Finger Spasticity

  • Kwak, Kyung-Woo;Kim, Min-Su;Chang, Chul-Hoon;Kim, Sang-Woo;Kim, Seong-Ho
    • Journal of Korean Neurosurgical Society
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    • 제50권2호
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    • pp.95-98
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    • 2011
  • Objective : This study aimed to evaluate the surgical outcomes of selective median neurotomy (SMN) for spastic wrist and fingers. Methods : We studied 22 patients with wrist and finger spasticity refractory to optimal oral medication and physical therapy. The authors evaluated spasticity of the wrist and finger muscles by comparing preoperative states with postoperative states using the modified Ashworth scale (MAS). We checked patients for changes in pain according to the visual analog scale (VAS) and degree of satisfaction based on the VAS. Results : The preoperative mean MAS score was $3.27{\pm}0.46$ ($mean{\pm}SD$), and mean MAS scores at 3, 6, and 12 months after surgery were $1.82{\pm}0.5$, $1.73{\pm}0.7$, and $1.77{\pm}0.81$ ($mean{\pm}SD$), respectively. On the last follow-up visit, the mean MAS score measured $1.64{\pm}0.9$ ($mean{\pm}SD$). Wrist and finger spasticity was significantly decreased at 3, 6, and 12 months after the operation (p<0.01). The preoperative mean pain VAS score was $5.85{\pm}1.07$ ($mean{\pm}SD$), and the mean pain VAS score on the last follow-up visit after surgery was $2.28{\pm}1.8$ ($mean{\pm}SD$). Compared with the preoperative mean pain VAS score, postoperative mean pain VAS score was decreased significantly (p<0.01). On the basis of a VAS ranging from 0 to 100, the mean degree of patient satisfaction was $64.09{\pm}15.93$ ($mean{\pm}SD$, range 30-90). Conclusion : The authors propose SMN as a possible effective procedure in achieving useful, long-lasting tone and in gaining voluntary movements in spastic wrists and fingers with low morbidity rates.

전기자극에 의한 근 수축이 V wave와 중앙주파수에 미치는 영향 (The Effects of Muscle Contraction by Electrical Stimulation to V Wave and Median Frequency)

  • 문달주;정대인;이정우;정진규;김태열;오명화
    • 대한임상전기생리학회지
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    • 제4권1호
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    • pp.27-38
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    • 2006
  • This study analyzed changes in action potential of supraspinal neuron and motor unit depending on maximum tolerance isometric contraction(MTIC) by electrical stimulation and examined influence of functional electrical stimulation (FES) on spinal neuron adaptation. It selected 40 university students in their twenties and divided into experimental groups of 25% MTIC(I), 50% MTIC I (II), 75% MTIC(III) and 100% MTIC(IV) depending on MTIC by electrical stimulation, and performed isometric contraction of plantar flexor muscle to each experimental group with given contraction for 20 times. It measured V/Mmax and MDF pre and post exercise, compared volume of contraction. 1. V/Mmax ratio showed no significant difference in comparison among experimental groups. 2. There was significant difference in median frequency of gastrocnemius and soleus in action potential motor unit according to comparison among experimental groups(p<.001). When contraction by electrical stimulation was maximum, change was greatest. This results suggest that muscle contraction by electrical stimulation was influence to action potential of spinal motor neuron system which appear optimal level though aspect and difference degree were not in accordance. Consequently, optimal stimulation level of MTIC(50%) by FES would be lead to central nerve adaptation. muscle contraction by electrical stimulation was influence highly to MDF which should be consider to fatigue of motor unit for muscle contraction by electrical stimulation.

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Subclinical Neuropathy at 'Safe' Levels of Lead Exposure

  • Seppalanen Anna Maria;Tola Sakari;Hernberg Sven;Kock Boria
    • 대한예방의학회:학술대회논문집
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    • 대한예방의학회 1994년도 교수 연수회(환경)
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    • pp.545-548
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    • 1994
  • Eletrophysiological methods revealed subclinical neuropathy in 26 workers, exposed from 1 to 17 years to lead and whose blood lead (PbB) values had never exceeded $70{\mu}g/100\;ml$, as ascertained by checking the monitor reports of the factory and by careful exposure history. The PbB determinations had been tested repostedly and had been found valid. The main findings were slowing of the maximal motor conduction velocities of the median and ulnar nerves and particularly the conduction velocity of the slower fibers of the ulnar nerve. Eletrophysiological abnormalities comprised fibriliations, diminution of the number of motor units on maximal contraction, and an abnormal. Thus, a dose-response relationship exlets on a group basis. Since the regular monitoring of PbBs in most workers during their entire period of exposure excludes the possibility of a body burden out of proportion to the PbBs silght neuro-logical damage is produced at exposures hitherto regarded as quite sale.

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Recurrent carpal tunnel syndrome associated with extension of flexor digitorum muscle bellies into the carpal tunnel: A case series

  • Castillo, Rochelle;Sheth, Khushboo;Babigian, Alan;Scola, Christopher
    • Archives of Plastic Surgery
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    • 제45권5호
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    • pp.474-478
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    • 2018
  • While the success or failure of carpal tunnel release ultimately depends on the interplay of a wide array of factors, a broad understanding of the normal anatomy of the carpal tunnel accompanied by awareness of the possible variations of the individual structures that make up its contents is crucial to optimizing surgical outcomes. While anatomic variants such as extension of the flexor digitorum muscle bellies have been described as a cause of primary carpal tunnel syndrome (CTS), there have been no reports depicting its association with recurrent CTS following initially successful carpal tunnel release, a finding with potentially significant prognostic implications that can aid in operative planning. In such cases where muscle extension is identified preoperatively, careful debulking of the muscle belly may be beneficial in improving long-term surgical outcomes.

만성 교약성 심낭염의 외과적 치료 (Pericardiectomy in Constrictive Pericarditis -23 Cases-)

  • 하현철
    • Journal of Chest Surgery
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    • 제28권2호
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    • pp.143-149
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    • 1995
  • From January, 1983, to August, 1993, 23 cases of pericardiectomy for chronic constrictive pericarditis were carried out. The 15 male and 8 female patients ranged in age from 7 to 68 years[mean 39.1 years . All patients underwent pericardiectomy through a median sternotomy. Postoperative complications were low cardiac output[2 patients , wound infection[2 patients , pneumonia[2 patients , and unilateral phrenic nerve palsy[2 patients . One patient died of low cardiac output 1 day after pericardiectomy due to the associated transposition of great artery and hypoplastic right lung. Clinical and pathological findings showed that the cause of constrictive pericarditis was tuberculous in 8 cases[34.8% , idiopathic in 12 cases[52.2% and pyogenic in 3 cases[13.0% . Central venous pressure fell below 10cmH2O by immediate in 6 cases, fell below 10cmH2O by 24hrs in 5 cases and continued above 10cmH2O after 24hrs in 12 cases. Preoperative NYHA functional class of patients showed class I-1, classII-4, class III-14, and class IV-3. Postoperativly NYHA functional class was improved to class I-15, classII-6, class III-1.

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Analyzing clinical and genetic aspects of axonal Charcot-Marie-Tooth disease

  • Kwon, Hye Mi;Choi, Byung-Ok
    • Journal of Genetic Medicine
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    • 제18권2호
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    • pp.83-93
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    • 2021
  • Charcot-Marie-Tooth disease (CMT) is the most common hereditary motor and sensory peripheral neuropathy. CMT is usually classified into two categories based on pathology: demyelinating CMT type 1 (CMT1) and axonal CMT type 2 (CMT2) neuropathy. CMT1 can be distinguished by assessing the median motor nerve conduction velocity as greater than 38 m/s. The main clinical features of axonal CMT2 neuropathy are distal muscle weakness and loss of sensory and areflexia. In addition, they showed unusual clinical features, including delayed development, hearing loss, pyramidal signs, vocal cord paralysis, optic atrophy, and abnormal pupillary reactions. Recently, customized treatments for genetic diseases have been developed, and pregnancy diagnosis can enable the birth of a normal child when the causative gene mutation is found in CMT2. Therefore, accurate diagnosis based on genotype/phenotypic correlations is becoming more important. In this review, we describe the latest findings on the phenotypic characteristics of axonal CMT2 neuropathy. We hope that this review will be useful for clinicians in regard to the diagnosis and treatment of CMT.

말초 신경병증을 초래한 건초주위 지방종 (Lipoma of the Tendon Sheath that Caused Peripheral Neuropathy)

  • 김세희;이용석;김재민
    • Clinical Pain
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    • 제20권1호
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    • pp.20-24
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    • 2021
  • In this case report, we present a rare case of lipoma of the tendon sheath localized to the wrist which caused median entrapment neuropathy and was successfully treated with surgical excision. Dynamic examination using ultrasonography revealed the exact location of the lipoma. Electrodiagnostic study (EDX) was done before surgery to elucidate combined neuropathy, and surgery for ulnar neuropathy around elbow was also performed simultaneously. Diagnostic ultrasound can be used for dynamic examinations with real-time visualization.

경피성 신경자극이 근전도 Power Spectrum과 압력통각역치에 미치는 영향 (The Effects of Transcutaneous Electric Nerve Stimulation (TENS) on the EMG Power Spectrum and Pressure Pain Threshold (PPT))

  • 김철;박문수
    • Journal of Oral Medicine and Pain
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    • 제32권4호
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    • pp.403-411
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    • 2007
  • 본 연구는 저작근의 과활성으로 유발된 근피로와 근육통증에 경피성 신경자극이 어떤 영향을 미치는지 평가하기 위해 측두하악장애의 병력과 현증이 없는 평균연령 26.1세인 29명의 정상 성인 (남자 18명, 여자 11명)을 대상으로 교근의 주관적 통증강도, 압력통각역치, 근전도 power spectrum의 변화양상을 측정하여 분석하였다. 모든 피험자는 적어도 3일 이상의 간격으로 2 회의 실험에 참여하여 하루는 실험군으로서 경피성 신경자극(TENS)을 적용하였고, 다른 하루는 대조군으로서 위경피성 신경자극(sham-TENS)을 적용하였다. 실험군과 대조군에서 각각 교근의 지속적인 등척성 수축 전과 후의 주관적 통증강도, 압력통각역치, 인내시간까지의 근수축 동안 근전도 power spectrum을 측정 분석하여 다음과 같은 결론을 얻었다. 1. 지속적인 등척성 수축으로 유발된 근피로 후의 압력통각역치와 중간주파수는 근피로 유발 전보다 유의하게 감소하였다. 2. 근피로 유발 전과 후의 압력통각역치는 TENS를 적용한 실험군에서 통계적으로 유의하게 증가하였다. 3. 근피로로 유발된 압력통각역치의 변화량은 TENS를 적용한 실험군에서 유의하게 감소하였다. 4. 근피로 후의 주관적 통증강도는 TENS를 적용한 실험군에서 유의하게 감소하였다. 5. 인내시간은 TENS를 적용한 실험군에서 증가하였고, sham-TENS를 적용한 대조군에서는 감소하였으나, 모두 통계적 유의성은 나타나지 않았다. 6. 인내시간 동안 중간주파수 변화량은 TENS를 적용한 실험군에서 더욱 적게 감소하였고 중간주파수 변화의 기울기는 더욱 크게 증가하였으나 모두 통계적 유의성은 나타나지 않았다.