• Title/Summary/Keyword: Nerve conduction studies

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Clinical Features of Wrist Drop Caused by Compressive Radial Neuropathy and Its Anatomical Considerations

  • Han, Bo Ram;Cho, Yong Jun;Yang, Jin Seo;Kang, Suk Hyung;Choi, Hyuk Jai
    • Journal of Korean Neurosurgical Society
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    • v.55 no.3
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    • pp.148-151
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    • 2014
  • Objective : Posture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy. Methods : Retrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records. Results : Subjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients. Conclusion : Wrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.

AN EXPERIMENTAL STUDY OF ELECTROPHYSIOLOGICAL AND HISTOLOGICAL ASSESSMENT ON THE INJURY TYPES IN RABBIT INFERIOR ALVEOLAR NERVE (가토의 하치조 신경 손상 형태에 따른 전기생리학적 및 조직학적 변화에 관한 실험적 연구)

  • Lee, Jae-Eun;Lee, Dong-Keun
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.18 no.4
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    • pp.679-700
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    • 1996
  • Inferior alveolar nerve dysfunction may be the result of trauma, disease, or iatrogenic injury. Inferior alveolar nerve injury is inherent risk in endodontic therapy, orthognathic surgery of the mandible, and extraction of mandibular teeth, particularly the third molars. The sensory disturbances of inferior alveolar nerve associated with such injury have been well documented clinical problem that is commonly evaluated by several clinical sensory test including Tinels sign, Von Frey test(static light touch detection), directional discrimination, two-point discrimination, pin pressure nociceptive discrimination, and thermal test. These methods used to detect and assess inferior alveolar nerve injury have been subjective in nature, relying on the cooperation of the patients. In addition, many of these techniques are sensitive to differences in the examiners experience and skill with the particular technique. Data obtained at different times or by different examiners are therefore difficult to compare. Prior experimental studies have used electro diagnostic methods(sensory evoked potential) to objectively evaluate inferior alveolar nerve after nerve injury. This study was designed with inferior alveolar nerve of rabbit. Several types of injury including mind, moderate, severe compression and perforation with 19 gauze, 21 gauze needle and 6mm, 10mm traction were applied for taking the sesory evoked ppterntial. Latency and amplitude of injury rabbit inferior alveolar nerve were investigated with sensory evoked potential using unpaired t-test. The results were as follows : 1. Intensity of threshold (T1) was $128{\pm}16{\mu}A$ : latency, $0.87{\pm}0.07$ microsecond : amplitude, $0.4{\pm}0.1{\mu}V$ : conduction velocity, 23.3 m/s in sensory evoked potential of uninjured rabbit inferior alveolar nerve. 2. Rabbit inferior alveolar nerve consists of type II and III sensory nerve fiber. 3. Latency was increased and amplitude was decreased in compression injury. The more injured, the more changed in latency and amplitude. 4. Findings in perforation injury was similar to compression injury. Waveform for sensory evoked potential improved by increasing postinjured time. 5. Increasing latency was prominent in traction injury rabbit inferior alveolar nerve. 6. In microscopic histopathological findings, significant degeneration and disorganization of the internal architecture were seen in nerve facicle of severe compression and 10mm traction group. From the above findings, electrophysiological assessment(sensory evoked potential) of rabbit injured inferior alveolar nerve is reliable technique in diagnosis and prognosis of nerve injury.

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The Effect of Irradiation During Resistance Exercise Using a Diagonal Pattern on the Excitability of Nerves (대각선 패턴에서 저항운동 시 발생한 방산의 효과가 신경의 흥분성에 미치는 영향)

  • Rhee, Min-Hyung;Choi, Su-Hong;Ha, Kyung-Jin;Lee, Sang-Yeol
    • PNF and Movement
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    • v.19 no.1
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    • pp.97-104
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    • 2021
  • Purpose: The human body can experience a variety of injuries. As a result, it may be difficult to directly treat the damaged area. In such a case, indirect treatment is required. Indirect treatment is typically PNF treatment. Morphological changes in muscle have been confirmed through several previous studies; however, few studies have analyzed neurological changes. Therefore, the purpose of this study was to determine how irradiation during resistance exercise using a diagonal pattern effects neurological excitability. Methods: Electromyography was performed on 13 healthy adults. A compound muscle action potential (CMAP) was obtained through a median motor nerve conduction velocity test, which was conducted before and after performing the irradiation exercise and general exercise. Results: Compared to baseline measurements, there was no significant difference in the latency of the irradiation exercise and general exercise. The amplitude of the CMAP measured after the irradiation exercise was significantly higher than after general exercise. Conclusion: Neurological excitability was high in irradiation during resistance exercise using a diagonal pattern. When clinically direct treatment is difficult, it is thought that irradiation can be used indirectly as a technique to induce nerve excitability.

Comparison of Weighted Needle Pinprick Sensory Thresholds and Sensory Nerve Conduction Studies in Diabetic Patients (당뇨병 환자에서의 가중침자 감각역치와 감각신경 전도검사와의 비교)

  • Ryoo, Jae-Kwan
    • Journal of Korean Physical Therapy Science
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    • v.3 no.1
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    • pp.929-941
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    • 1996
  • This study was conducted to determine the association between weighted needle pinprick sensory threshold(PPT) and sensory nerve conduction studies. The subjects were 53 healthy controls, 31 diabetic patients without peripheral neuropathic symptoms(DM) and 36 diabetic patients with peripheral neuropathic symptoms(DN). PPT was measured on the index and little fingers, bilaterally, as well as under the lateral malleolus, bilaterally. In electrophysiologic assessment the left and right median, ulnar and sural nerves were studied. Mean PPT in DN, DM and controls was high in turn on each sites tested. Age controlled PPT was significantly different among three groups on right little finger(p<0.05) and left malleolus(p<0.05), but on other sites, not statistically significantly different between DN and DM. The results were as follows: Sensory nerve conduction velocity and amplitude on each nerve tested were statistically significantly different among three groups(p<0.05). Correlation of PPT with sensory nerve conduction velocity and amplitude were statistically significant on each site and ranged from -0.4203(left malleolus) to -0.5649(right index finger) and from -0.3897(left index finger) to -0.6200(right index finger), respectively. When electrophysiological study is not feasible, measurement of PPT may be helpful for the assessment of peripheral sensory neurological function.

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Sensory Nerve Conduction Velocity of Median Proper Palmar Digital Nerve Recorded by Bar Electrode (막대전극을 이용하여 기록한 정중고유손바닥쪽 손가락신경의 감각신경전도속도)

  • Kwak, Kyo Ho;Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.2 no.1
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    • pp.21-26
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    • 2000
  • Background: There has been few electrophysiologic studies in median proper palmar digital nerve(PPDN). Bar electrode may be a useful tool to evaluate the pathophysiologic state of the distal peripheral nerves. Objectives : To evaluate sensory nerve conduction velocities(NCVs) of median PPDNs in normal controls and carpal tunnel syndrome(CTS) patients by bar electrode, and clarify the usefulness of the bar electrode. Methods : We checked NCV of each median PPDN of thumb(D1), index(D2) and middle finger(D3) in normal controls(68 hands) and CTS patients(95 hands) by bar electrode. The each mean NCV of both groups were compared to find the correlation between them. Results : The mean NCV of each median PPDN in control group were $38.7{\pm}4.2$(D1), $32.0{\pm}4.6$(D2), $34.2{\pm}4.4$(D3) m/sec, and in CTS group were $35.3{\pm}8.9$(D1), $20.2{\pm}5.2$(D2), $20.2{\pm}5.1$(D3) m/sec orderly. There were significant differences between mean NCV of each finger in control group(p=0.0001), but not between each left and right finger(p>0.05). The differences between each mean NCV of control and CTS were significant in all 3 fingers(p=0.0014, 0.0000, 0.0000). Conclusion : Bar electrode is a useful tool to evaluate the pathophysiologic state of the median PPDNs in normal controls and CTS patients.

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Distal acquired demyelinating symmetric neuropathy associated with anti-GM1 and anti-GD1b antibodies

  • Ko, Keun Hyuk;Jwa, Seung-Joo;Park, Sung Joo;Kang, Sa-Yoon
    • Annals of Clinical Neurophysiology
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    • v.19 no.1
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    • pp.54-57
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    • 2017
  • Distal acquired demyelinating symmetric (DADS) neuropathy is a variant form of chronic inflammatory demyelinating polyradiculoneuropathy. A 54-year-old man presented with gait disturbance owing to weakness in both legs. Nerve conduction studies showed demyelinating sensorimotor polyneuropathy, and laboratory studies demonstrated anti-GM1 and anti-GD1b IgG antibodies, but no anti-myelin associated glycoprotein activity. We suggest that an antiganglioside antibodies assay needs to be applied when DADS neuropathy is suspected in order to improve the classification of dysimmune neuropathies.

A case of Bickerstaff's brainstem encephalitis in childhood (Bickerstaff 뇌간 뇌염 1례)

  • Kim, Ji-Youn;Kim, Young-Ok;Son, Young-Jun;Woo, Young-Jong
    • Clinical and Experimental Pediatrics
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    • v.53 no.4
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    • pp.607-611
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    • 2010
  • Bickerstaff's brainstem encephalitis (BBE) is a rare disease diagnosed by specific clinical features such as 'progressive, relatively symmetric external ophthalmoplegia and ataxia by 4 weeks' and 'disturbance of consciousness or hyperreflexia' after the exclusion of other diseases involving the brain stem. Anti-ganglioside antibodies (GM, GD and GQ) in the serum or cerebrospinal fluid (CSF) are sometimes informative for the diagnosis of BBE because of the rarity of positive findings in other diagnositic methods: brain magnetic resonance imaging (MRI), routine CSF examination, motor nerve conduction study, and needle electromyography. We report a rare case of childhood BBE with elevated anti-GM1 antibodies in the serum, who had specific clinical symptoms such as a cranial polyneuropathy presenting as ophthalmoplegia, dysarthria, dysphagia, and facial weakness; progressive motor weakness; altered mental status; and ataxia. However, the brain MRI, routine CSF examination, nerve conduction studies, electromyography, somatosensory evoked potentials, and brainstem auditory evoked potentials were normal. BBE was suspected and the patient was successfully treated with intravenous immunoglobulins.

Simple Decompression of the Ulnar Nerve for Cubital Tunnel Syndrome

  • Cho, Yong-Jun;Cho, Sung-Min;Sheen, Seung-Hoon;Choi, Jong-Hun;Huh, Dong-Hwa;Song, Joon-Ho
    • Journal of Korean Neurosurgical Society
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    • v.42 no.5
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    • pp.382-387
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    • 2007
  • Objective : Cubital tunnel syndrome is the second most common entrapment neuropathy of the upper extremity. Although many different operative techniques have been introduced, none of them have been proven superior to others. Simple cubital tunnel decompression has numerous advantages, including simplicity and safety. We present our experience of treating cubital tunnel syndrome with simple decompression in 15 patients. Methods : According to Dellon's criteria, one patient was classified as grade 1, eight as grade 2, and six as grade 3. Preoperative electrodiagnostic studies were performed in all patients and 7 of them were rechecked postoperatively. Five patients of 15 underwent simple decompression using a small skin incision (2 cm or less). Results : Preoperative mean value of motor conduction velocity (MCV) within the segment (above the elbow-below the elbow) was $41.8{\pm}15.2\;m/s$ and this result showed a decrease compared to the result of MCV in the below the elbow-wrist segment ($57.8{\pm}6.9\;m/s$) with statistical significance (p<0.05). Postoperative mean values of MCV were improved in 6 of 7 patients from $39.8{\pm}12.1\;m/s$ to $47.8{\pm}12.1\;m/s$ (p<0.05). After an average follow-up of $4.8{\pm}5.3$ months, 14 patients of 15 (93%) reported good or excellent clinical outcomes according to a modified Bishop scoring system. Five patients who had been treated using a small skin incision achieved good or excellent outcomes. There were no complications, recurrences, or subluxation of the ulnar nerve. Conclusion : Simple decompression of the ulnar nerve is an effective and successful minimally invasive technique for patients with cubital tunnel syndrome.

Comparison of Weighted Needle Pinprick Sensory Thresholds and Sensory Nerve Conduction Studies in Diabetic Patients (당뇨병(糖尿病) 환자(患者)에서의 가중침자(加重針刺) 감각역치와 감각신경(感覺神經) 전도검사(傳導檢査)와의 비교(比較))

  • Yoo, Jae-Kwan;Kim, Seong-Ah;Lee, Jong-Young
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.899-910
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    • 1995
  • This study was conducted to determine the correlation between weighted needle pinprick sensory threshold(PPT) and sensory nerve conduction tests. The subjects were 53 healthy controls, 31 diabetic patients without peripheral neuropathic symptoms(DM) and 36 diabetic patients with peripheral neuropathic symptoms(DN). PPT was measured on the index and little fingers, bilaterally, as well as under the lateral malleolus, bilaterally. In electrophysiologic assessment the left and right median, ulnar and sural nerves were studied. Each mean PPTs was high in order of controls, DM and DN. Age adjusted PPT was significantly different among three groups on right little finger(p<0.05) and left malleolus(p<0.05), but not significantly different between DN and DM on other sites. Each sensory nerve conduction velocity and amplitude was statistically significantly different among three groups(p<0.05). Correlations of PPT with sensory nerve conduction velocity and amplitude were statistically significant on each site and ranged from -0.4203(left malleolus) to -0.5649(right index finger) and from -0.3897(left index finger) to -0.6200(right index finger), respectively. When electrophysiological study is not feasible, measurement of PPT may be helpful for the assessment of peripheral sensory neurological function.

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A review of herbal medicines for chemotherapy induced peripheral neuropathy (한약을 이용한 chemotherapy-induced peripheral neuropathy (CIPN) 치료 관련 무작위 배정 임상 시험에 대한 고찰)

  • Park, Bongki
    • Journal of Korean Traditional Oncology
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    • v.21 no.2
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    • pp.51-61
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    • 2016
  • Background : Chemotherapy-induced peripheral neuropathy (CIPN) is a common adverse effect in cancer patients who were exposed to chemotherapy. CIPN impacts on the quality of life and could delay chemotherapy. The aim of this review was to assess the therapeutic effectiveness of herbal medicine in CIPN patients. Methods : Randomized controlled trials (RCTs) were included in this review. We searched MEDLINE, Cochrane database, EMBASE, CNKI, Wanfang and four Korean databases without restrictions on time or language. The risk of bias was assessed using the Cochrane risk of bias tool. Results : Eleven RCTs involving 706 patients met the inclusion criteria. Eleven different herbal medicines were examined in the included trials. Almost RCTs showed insufficiency in the reporting randomization method and allocation concealment. One trial used allocation concealment and a double-blinding method. Five studies reported that participants dropped out of RCTs and conducted an 'as-treated analysis'. One trials reported adverse effects of herbal medicine. In ten of the eleven trials, the use of herbal medicine had shown significant differences in clinical symptoms or nerve conduction velocity. Conclusions : The use of herbal medicines for CIPN showed significant improvements in the management of CIPN. However, conclusions cannot be drawn because of the generally low quality of methodology and low quantity of data for each single herbal medicine. Further rigorous trials are needed.