• Annals of Clinical Neurophysiology
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• v.12 no.1
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• pp.16-20
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• 2010

Background: The medial plantar nerve (MPN) is a distal branch of the posterior tibial nerve, and various methods of nerve conduction study for MPN have been introduced so far. Hemmi et al described a new method (Hemmi's method) for recording medial plantar sensory nerve action potentials (SNAPs), which is considered as a simple and reliable method for measuring medial plantar SNAPs. This study was aimed to establish the normal values for the MPN conduction study among Koreans and to compare the sensitivities of three different methods for MPN conduction study (Hemmi, Oh, and Saeed's method) in detecting evidence of peripheral neuropathy among diabetic patients. Methods: In 27 healthy subjects, MPN conduction study using Hemmi's method was performed and normal values were calculated. In 54 diabetic patients who showed normal routine nerve conduction studies, three different methods for MPN conduction study were performed and diagnostic sensitivity of each method were compared. Results: In normal subjects, the mean medial plantar SNAP amplitude and conduction velocities measured by Hemmi's method were $4.3{\pm}1.0$ uV and $38.3{\pm}6.8$ m/s respectively. Among 54 patients with diabetes who showed normal routine nerve conduction studies, medial plantar SNAP was not obtainable in 28, 31, and 6 patients by Hemmi, Oh and Saeed's method respectively. Conclusions: In terms of the diagnostic sensitivity for detecting diabetic neuropathy, there had been no significant statistical difference between three different methods. Our study suggested that MPN conduction study using Hemmi's method is simple and useful screening test for early diabetic neuropathy, and is comparable with Oh's method.

• Annals of Clinical Neurophysiology
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• v.3 no.1
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• pp.15-20
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• 2001

Background : Carpal tunnel syndrome(CTS) is the most common entrapment neuropathy that refers to a group of signs and symptoms resulting from compression of the median nerve at the wrist. The course of CTS in older patients is different from the younger patients. This difference may be the result of different underlying mechanisms. The different nerve conduction studies of CTS may signify different approaches in management. This study was done to assess the differences in nerve conduction study of CTS in younger and older patients. Methods : This study involved 224 patients who visited Gachon Medical School, Gil Medical Center and was diagnosed by nerve conduction study from October 1997 to October 1999. We compared the results of nerve conduction study to age, especially in between those under 60 years and those 60 years or over CTS patients. Nerve conduction study consists of motor studies of both median nerves(terminal latency, compound action potential) and sensory studies(nerve conduction velocity, nerve action potential). And we also evaluated the variables between younger and older patients group. Those variables include sex, symptom period, laterality, abnormal physical findings and radiculopathy. Results : We found that a significant increase of terminal latency(p<0.1), but a decrease in compound motor action potential(p<0.05) in older patient's group. There was no significant differences in sensory nerve conduction velocity and action potential between those under 60 years and those 60 years or even patients. And also there was no significant difference in sex, symptom period, laterality, abnormal physical findings, radiculopathy between older and younger patients. Conclusions : This study showed a significant increase in the terminal latency and a decrease in compound action potential in older patients. The different nerve conduction studies of CTS by age effect may need different approaches in management.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.199-212
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• 1998

The purpose of this article is to summary about the application of electromyography and nerve conduction study. Electrodiagnostic studies, which include nerve conduction studies, electromyography, repetitive nerve stimulation, single fiber EMG, late response tests and evoked potential tests are a critical component of the neuromuscular evaluation.

• Journal of Korean Physical Therapy Science
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• v.5 no.2
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• pp.603-616
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• 1998

The purpose of this article is to summary about the application of electromyography and nerve conduction study. Electrodiagnostic studies, which include nerve conduction studies, electromyography, repetitive nerve stimulation, single fiber EMG, late response tests and evoked potential tests are a critical component of the neuromuscular evaluation.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.97-100
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• 2005

Background: The most distal sensory fibers of the feet are often affected first in polyneuropathy. However, they are not evaluated in routine nerve conduction studies. Thus we evaluated the dorsal sural sensory nerve in patients with sensorimotor polyneuropathy with normal sural response, in order to assess the usefulness in electrodiagnostic practice. Methods: In this study, 53 healthy subjects and 27 patients with clinical evidence of sensorimotor polyneuropathy were included. In all subjects, peripheral motor and sensory nerve studies were performed on the upper and lower limbs including dorsal sural nerve conduction studies. On electrodiagnostic testing, all patients had normal sural responses. Results: The dorsal sural sensory nerve action potentials (SNAPs) mean amplitude was $13.12{\pm}5.68{\mu}V$, mean latency was $3.12{\pm}0.43msec$, and mean sensory conduction velocity (SCV) was $36.50{\pm}3.40m/s$ in healthy subjects. In 7 of 27 patients, the dorsal sural nerve SNAPs were absent bilaterally, and in 20 patients, the mean dorsal sural nerve distal latency was longer($3.40{\pm}0.48ms$, P=0.006), and mean SCV was slower than in healthy subjects($35.08{\pm}4.59$, P=0.043). However, dorsal sural nerve amplitude was not different between the groups (P=0.072). Conclusions: Our findings suggest that dorsal sural nerve conduction studies should be included in the routine electrodiagnostic evaluation of patients with suspected polyneuropathy and normal sural nerve responses.

• The Journal of the Korea Contents Association
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• v.10 no.10
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• pp.237-245
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• 2010

Nerve conduction studies (NCS) are the most objective measure of nerve function and essential for the diagnosis of sub-clinical neuropathy in diabetes mellitus and diabetic polyneuropathy (DPN). This study evaluates the characteristic of electrophysiological abnormalities in DPN. Electrodiagnostic data from 120 patients with diabetic polyneuropathies and 77 control subjects were reviewed. Motor nerve conduction velocities (MNCV), distal motor latencies (DML), compound muscle action potential (CMAP) amplitudes, No potential frequency and conduction block were analyzed. Data were normalized based on normative reference values, and the proportion of nerves with abnormal values in the lower and upper limbs were evaluated. DPN was systemic demyelinating peripheral polyneuropathy and more severe abnormal nerve conduction was found in lower limbs than in upper limbs. The abnormal degree was more severe in peroneal nerve. It was no statistically significant difference of conduction block in control and DPN group. Our findings suggest that DPN had more common and severe peroneal nerve involvement in the motor nerve conduction studies (MNCS). These findings have important implications for the electrophysiological evaluation of DPN.

• Journal of Medicine and Life Science
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• v.15 no.2
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• pp.101-104
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• 2018

Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy caused by focal compression of the median nerve in the carpal tunnel. However, many patients with CTS, who are diagnosed clinically and confirmed with electrophysiological studies, complain of the sensory symptoms extends to the ulnar nerve territory. The aim of this study was to evaluate whether a dysfunction in sensory fibers of the ulnar nerve was present or not in hands with CTS patients who had extramedian spread of sensory symptoms over the hand. We retrospectively analyzed the recording of the subjects who were diagnosed with CTS within a one-year-period of time. After exclusions, 136 hands recordings of 87 patient were included. We compared the results of median and ulnar nerve sensory conduction studies between normal hands and hands with CTS. We did not detect statistically significant difference on all parameters of ulnar nerve sensory conduction studies between the normal hands and the hands with CTS. The parameters of the obtained in median nerve sensory conduction studies were statistically different between the healthy control and CTS patients. The hands with CTS showed similar rate of ulnar sensory conduction abnormalities compared with the normal hands. In conclusion, our study showed that none of the parameters in ulnar sensory nerve conduction studies differ between two groups. Accordingly, our study revealed that ulnar nerve involvement does not contribute in CTS patients underlying the spread of paresthesia extends to the ulnar nerve territory.

• Annals of Clinical Neurophysiology
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• v.1 no.2
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• pp.118-125
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• 1999

Background and Aims : Nerve conduction study is invaluable in clinical neurology, especially for assessing peripheral neuropathies. Abnormal nerve conduction studies may result not only from peripheral nerve dysfunction itself, but also from other various mechanical, technical, and physiological factors such as age, sex, height and temperature. So we conducted this study to establish the our own normal values. Methods : In this study, from March. 1997 to July. 1998, 40 Korean adults among person came to Health Promotion Center over the age of 20 without any suspicion of neurological deficits were analysed to determine the effect of compound effects of several physiological factors. Results : The nerve conduction velocities of the upper extremity and proximal segments were faster than those of the lower extremity and distal segments. Physiological factors such as age, height and temperature affect the results of nerve conduction studies in multiple regression analysis. The sex difference is recognized over peroneal motor nerve. There are no sex differences in amplitude transformed into normal distribution. The significant physiological factor affecting the amplitude of nerve conduction is age, whereas height and temperature play no role. Conclusions : In multiple regression analysis, height is widespread variable for the nerve conduction velocities and temperature is important variable for lower extremities. The parametric statistical analysis cannot be applied to the amplitude of the compound muscle or nerve action potentials because of marked left shift in distribution. Sqareroot transformation of the CMAP and CNAP may be useful in normalizing the distribution. The most significant physiological factor affection the amplitude is age. Sex differences are not seen in nerve conduction study.

• Annals of Clinical Neurophysiology
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• v.7 no.2
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• pp.83-87
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• 2005

Background: The study of the medial antebrachial cutaneous nerve (MABCN) is an underused electrodiagnostic tool. But its use is often crucial for assessing mild lower brachial plexus or MABCN lesions, and sometimes for differentiating an ulnar mononeuropathy from a lower brachial plexopathy. This study was designed to know the difference of amplitude and velocity in a stimulation method (orthodromic vs antidromic), side of an arm and sex according by age. Method: MABCN conduction studies were performed orthodromically and antidromically in 90 subjects (42 women and 48 men, ranging from 22 to 79 years of age). We divided subjects into three groups by age (group 1: 20-39 years, group 2: 40-59 years, group 3: 60-79 years). The mean sensory nerve action potential amplitudes and sensory nerve conduction velocities in each group was compared by stimulation method, side of an arm and sex. Result: The amplitudes and velocities made a significant difference between orthodromic and antidromic method in all age groups. At comparison in amplitude and velocity by side of an arm, only amplitude was significantly higher in right arm than left by any stimulation method. The amplitudes and velocities were of no statistically differences in sex except amplitude checked orthodromically in right arm. Conclusion: This study suggests that there is the differences in conduction study of MABCN by stimulation method and side of an arm.

• Annals of Clinical Neurophysiology
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• v.21 no.1
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• pp.36-43
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• 2019

Background: Diabetic peripheral polyneuropathy (DPN) is associated with a variety of symptoms. Nerve conduction studies (NCSs) are considered to be the gold standard of nerve damage assessments, but these studies are often dissociated from the subjective symptoms observed in DPN patients. Thus, the aim of the present study was to investigate the correlations between NCS parameters and neuropathic symptoms quantified using the Michigan Neuropathy Screening Instrument (MNSI). Methods: Patients with type 2 diabetes mellitus (T2DM) with or without symptoms of neuropathy were retrospectively enrolled. Demographic data, clinical laboratory data, MNSI score, and NCS results were collected for analysis; DPN was diagnosed based on the MNSI score (${\geq}3.0$) and abnormal NCS results. Pearson's correlation coefficients were used to evaluate the relationships between MNSI score and NCS variables. Results: The final analyses included 198 patients (115 men and 83 women) with a mean age of $62.6{\pm}12.7$ years and a mean duration of diabetes of $12.7{\pm}8.4$ years. The mean MNSI score was 2.8 (range, 0.0-9.0), and 69 patients (34.8%) were diagnosed with DPN. The MNSI score was positively correlated with the median motor nerve latency and negatively correlated with the median motor, ulnar sensory, peroneal, tibial, and sural nerve conduction velocities (NCVs). When the patients were categorized into quartiles according to MNSI score, peroneal nerve conduction velocity was significantly lower in the second MNSI quartile than in the first MNSI quartile (p = 0.001). A multivariate analysis revealed that the peroneal NCV was independently associated with MNSI score after adjusting for age, sex, and glycosylated hemoglobin A1c (HbA1c) levels. Conclusions: The present results indicate that a decrease in peroneal NCV was responsible for early sensory deficits in T2DM patients.