• Title/Summary/Keyword: Peripheral nerve injury

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Serial Electrophysiological Studies in Miller Fisher Syndrome (Miller Fisher 증후군1예에서 일련의 신경생리학적 소견)

  • Jun, Dong Chul;Park, Chun-Kang;Lee, Kyu-Yong;Lee, Young Joo;Kim, Juhan
    • Annals of Clinical Neurophysiology
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    • v.3 no.2
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    • pp.156-159
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    • 2001
  • Miller Fisher syndrome(MFS) has been the focus of conflicting opinions regarding the peripheral versus the central nature of the site of major neural injury. We present our electrophysiological findings in one case of MFS to help clarify the pattern of peripheral nerve injury in this syndrome. A 45-year-old man visited our hospital due to sudden diplopia. Initial examination revealed internuclear opthalmoplegia. The next day, his symptoms rapidly aggravated to complete external ophthalmoplegia, ataxia, and areflexia with hand and foot numbness. Serial electrophysiological studies were performed. The results of brainstem evoked potential(BAEP) and blink reflex were normal in the serial studies. Motor and sensory nerve conduction study(NCS) were normal findings in second hospital day, but ulnar sensory nerve shows no sensory nerve action potential(SNAP) and sural sensory conduction velocity was delayed in 7th hospital day. Our patient's clinical presentation began to improve on 15th hospital day, and his electrophysiologic study showed improvement on 29th hospital day. We believe that all the manifestations of MFS can be explained by the involvement of peripheral nerves without brainstem or cerebellar lesion with the serial electrophysiological studies.

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Effect of Electroacupuncture on the Regeneration of Injured Peripheral Nerve (손상된 말초신경의 재생에 미치는 전자침의 효과)

  • Deung, Young-Kun;Kim, Dong-Heui;Kang, Song-Jian
    • Applied Microscopy
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    • v.32 no.1
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    • pp.1-8
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    • 2002
  • To confirm the effect of electroacupuncture on the regeneration of injured peripheral nerve, the change of evoked potential in the sciatic nerve, the change of enzyme activity in the spinal cord, and morphological change of injured sciatic nerve were examined comparatively in acupuncture group (AG) and control group (CG) after sciatic nerve of guinea pig was injured by purpose. The value of evoked potential after injury of the sciatic nerve was increased in both AG and CG, but the increase rate of that was higher in AG than CG. Acid phosphatase activity of the spinal cord was increased in 1CG and 2AG, but shown are tendency to return to the normal state as time went by. Ultrastructural recovering rate of the injured sciatic nerve was higher in AG than CG. Also, there was developed only adipose tissue in sciatic nerve of AG. As mentioned above, the effect of electroacupuncture on the regeneration of injured peripheral nerve was confirmed experimentally by change of evoked potential, acid phosphatase and ultrastructure. Especially, the effect of electroacupuncture was appeared clearly in an early stage than other treatment stages.

Peripheral Nerve Injuries Related to Local Dental Clinic Anesthesia in the Dental Clinic (치과에서 발생하는 국소마취에 의한 신경손상)

  • Kim, Hyun Jeong
    • Journal of The Korean Dental Society of Anesthesiology
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    • v.14 no.2
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    • pp.89-94
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    • 2014
  • Local anesthesia known as the safe and essential procedure to control pain in dentistry may cause sensory changes such as paresthesia or altered taste at the affected sites after even successful local anesthesia. Although the prognosis of the nerve injuries after local anesthesia is favorable, it might cause prolonged problems such as dysesthesia. The lingual nerve is a single fascicle at the level of the lingual among 1/3 of patients and more movable during regeneration compared to the inferior alveolar nerve after the injury. As a result, the lingual nerve is more vulnerable and has poorer outcomes. More vigilant clinical considerations are required to the lingual nerve injury after local anesthesia. Generally, more than 80% of cases are spontaneously resolved within 2 weeks after the local anesthesia even without any specific treatment. However, the patient having long lasting abnormal sensations more than 2 weeks needs specialists' care for further assessment. In case of dysesthesia which is a symptom of neuropathic pain, immediate referral to specialists is mandatory. The exact mechanism, how to prevent its occurrence, or specific treatments of the nerve injury related to the local anesthesia have not been elucidated. To prepare clinical or medicolegal problems, many cautious considerations are given to the patients who complain sensory changes after local anesthesia.

Peripheral Nerve Regeneration After Various Conditioned Side to Side Neurorrhaphy in Rats (말초신경 손상 후 측측문합을 이용한 신경이식시 신경이식의 수에 따른 신경재생 및 근육 기능 회복에 관한 비교 연구)

  • Kim, Sug-Won;Chung, Yoon-Kyu;Kang, Sang-Yoon;Cho, Pil-Dong
    • Archives of Reconstructive Microsurgery
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    • v.10 no.1
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    • pp.12-17
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    • 2001
  • Recovery of nerve injury is conditioned by various factors including physical state, injured site, cause of injury, and neurorrhaphy Many researchers have reported on regeneration of nerve using end to side neurorrhaphy. The purpose of this study was to examine regeneration of nerve in various conditioned side to side neurorrhaphy. Total of 25 male Sprague-Dawley rats weighing 220 to 250 gm were divided into five groups of five rats each. The group 1, sham group, composed of dissection only without nerve transaction. The group 2, control group, composed of nerve division only without neurorrhaphy or sural nerve graft. The group 3 composed of one segmental sural nerve graft between the tibial and peroneal nerve after division. Group 4 had two segment graft, and the group 5 with three segment graft, each segment being 6mm long and 5 mm apart. The side to side neurorrhaphy was performed between peroneal nerve and tibial nerve using segmental sural nerve graft in rats. We exposed the sciatic nerve, tibial nerve, peroneal nerve, and sural nerve on left side with prone position. The peroneal nerve was cut on the bifurcation site from tibial nerve and the side to side epineurial neurorrhaphy was performed between peroneal nerve and tibial nerve through 6 mm sural nerve segment graft with 11-0 nylon under operating microscope. The electromyography and the weight from ipsilateral tibialis anterior muscle was performed at one month after neurorrhaphy Peroneal and tibial nerve was examined at distal and proximal to the neurorrhaphy site by methylene blue stain under light microscope for histologic appearance. The number of nerve fibers were counted using the image analyzer. Statistically, both in electromyography and number of nerve fibers, the differences in values between the groups were significant.

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The Effect of Micro-current Electrical Therapy on Muscle Atrophy and Delayed Wound Healing Process Induced Rat Caused by Traumatic Peripheral Nerve Injury (외상성 말초신경 손상으로 인한 창상 치유 지연 및 근위축이 유발된 소동물에서의 미세전류 자극 효능 평가)

  • Lee, Hana;Kim, Seohyun;Hwang, Donghyun;Yoo, Lee;Yu, Jihee;Kim, Minju;Cho, Seungkwan;Kim, Han Sung
    • Journal of Biomedical Engineering Research
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    • v.39 no.1
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    • pp.1-9
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    • 2018
  • This study was carried out to evaluate the effect of micro-current therapy on muscle atrophy and delayed wound healing process caused by traumatic peripheral nerve injury. For this, twenty-five 5-week-old Sprague Dawley rat were used and assigned to five groups including the normal group (NOR, n=5), the wound group (WD, n=5), the wounded and treated with micro-current electrical therapy group (WD+MET, n=5), the sciatic nerve denervated and wounded group (WD+DN, n=5), and the sciatic nerve denervated, wounded and treated with micro-current electrical therapy group (WD+DN+MET, n=5). In order to assess the changes in length of incisional wound for 12 days and the muscle volume for 2 weeks, the ImageJ analysis of macroscopic analysis and micro-CT data were obtained and analyzed. As a result, significant delay in the process in wound healing were observed and micro-current therapy suppress the postponement of healing process. Furthermore, there were significant changes in muscle volume between electrically treated group and non-treated group. These result shows that electrical stimulation may improve the delayed healing process and muscle atrophy at once.

The Effect of Electrical Stimulation on MAP2 Expression in the Cerebral Cortex following Sciatic Nerve Crush Injury in Rat (흰쥐 좌골신경손상 후 전기 자극이 대뇌피질에서의 MAP2 발현에 미치는 영향)

  • Ahn, Eun-Young;Kim, Jin-Sang
    • The Journal of Korean Physical Therapy
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    • v.17 no.3
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    • pp.391-401
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    • 2005
  • The purpose of this study was to investigate the effect of electrical stimulation(EST) on MAP2(Microtubule Associated Protein 2) expression in cerebral cortex following sciatic nerve crush injury in rats. Twelve Sprague-Dawley adult female rats, six for control and six for experimental, were anesthetized and their sciatic nerves were crushed. The electrical stimulation (EST) was applicated with 3 Hz for 10 minuties in a day for muscles innervated sciatic nerve. The MAP2 expression in cerebral cortex was identified from immunohistochemistry against MAP2. The result of this study were as follow: 1) In control group, MAP2 immunoreactive neurons were observed but there no significant increase for 3 days. 2) MAP2 immunoreactive neurons were increased markably in experimental group than control group. 3) MAP2 immunoreactive neurons were increased markably after applicating with EST in sciatic nerve crush injury induced group from 2nd day. This study showed that the application of EST for muscles after sciatic nerve crushed injury made MAP2 immunoreactive neurons in the cerebral cortex increased. Therefore, the electrical stimulation on the peripheral site, denervated muscle, may facilitate MAP2 expression in the cerebral cortex.

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Surgical Anatomy of Sural Nerve for the Peripheral Nerve Regeneration in the Oral and Maxillofacial Field (구강악안면 영역의 말초신경 재생을 위한 비복신경의 외과적 해부학)

  • Seo, Mi-Hyun;Park, Jung-Min;Kim, Soung-Min;Kang, Ji-Young;Myoung, Hoon;Lee, Jong-Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.2
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    • pp.148-154
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    • 2012
  • Peripheral nerve injuries in the oral and maxillofacial regions require nerve repairs for the recovery of sensory and/or motor functions. Primary indications for the peripheral nerve grafts are injuries or continuity defects due to trauma, pathologic conditions, ablation surgery, or other diseases, that cannot regain normal functions without surgical interventions, including microneurosurgery. For the autogenous nerve graft, sural nerve and greater auricular nerve are the most common donor nerves in the oral and maxillofacial regions. The sural nerve has been widely used for this purpose, due to the ease of harvest, available nerve graft up to 30 to 40 cm in length, high fascicular density, a width of 1.5 to 3.0 mm, which is similar to that of the trigeminal nerve, and minimal branching and donor sity morbidity. Many different surgical techniques have been designed for the sural nerve harvesting, such as a single longitudinal incision, multiple stair-step incisions, use of nerve extractor or tendon stripper, and endoscopic approach. For a better understanding of the sural nerve graft and in avoiding of uneventful complications during these procedures as an oral and maxillofacial surgeon, the related surgical anatomies with their harvesting tips are summarized in this review article.

Effect of Aqueous Extract of Sukjiyanggeun-Tang(shudiyangjin-tang) on Functional Recovery and Expressions of Inflammatory Mediators after Sciatic Nerve Crushed Injury in Rat (숙지양근탕(熟地養筋湯) 추출물이 흰쥐 좌골신경 손상 후에 기능회복과 염증 매개 인자 발현에 미치는 영향)

  • Jang, Gun;Song, Yun-Kyoung;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.33-48
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    • 2013
  • Objectives : Peripheral nerve injuries are commonly encountered clinical problems and often result in severe functional deficits. Sukjiyanggeun-Tang(shudiyangjin-tang), in oriental medicine, has been used to treat various musculoskeletal disorders. Methods : In the present study, the effects of aqueous extract of Sukjiyanggeun-Tang(shudiyangjin-tang) on functional recovery, severity of pain, and expressions of neurofilament, cycloxygenease-2(COX-2), inducible nitric oxide synthase(iNOS), and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) following sciatic crushed nerve injury in rats were investigated. For this study, walking tract analysis, plantar test, western blot analysis for COX-2 iNOS, and TNF-${\alpha}$, and Immunofluorescence test for neurofilament were performed. Results : In the present results, sciatic functional index(SFI) in walking tract analysis was significantly decreased following sciatic crushed nerve injury, and pain severity in plantar test was significantly increased. COX-2, iNOS and TNF-${\alpha}$ expressions were increased whereas neurofilament expression was decreased by sciatic crushed nerve injury, In contrast, treatment with Sukjiyanggeun-Tang(shudiyangjin-tang) improved SFI in walking tract analysis and suppressed the pain severity in sciatic crushed nerve injury. Sukjiyanggeun-Tang(shudiyangjin-tang) treatment also suppressed COX-2, iNOS, and TNF-${\alpha}$ expressions and enhanced the neurofilament expression in sciatic crushed nerve injury. Conclusions : In the present study, we have shown that Sukjiyanggeun-Tang(shudiyangjin-tang) is the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury.

Effect of Bee Venom Pharmacopuncture and Scolopendra Subspinipes Pharmacopuncture on Functional Recovery and Anti-inflammation after Sciatic Crushed Nerve Injury in Rats (봉독약침과 오공약침이 좌골신경 손상 흰쥐의 기능 회복과 염증 억제에 미치는 영향)

  • Lee, Gill-Jae;Song, Yun-Kyoung;Lim, Hyung-Ho
    • Journal of Korean Medicine Rehabilitation
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    • v.23 no.2
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    • pp.17-31
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    • 2013
  • Objectives : Peripheral nerve injuries are commonly encountered clinical problems and often result in serve functional deficit. Bee venom and scolopendra subspinipes have been traditionally used in oriental medicine to treat several inflammatory diseases and chronic pain conditions. Methods : In the present study, the effects of bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture on functional recovery, severity of pain, and expressions of neurofilament, cycloxygenease-2(COX-2), and tumor necrosis factor-${\alpha}$(TNF-${\alpha}$) following sciatic crushed nerve injury in rats were investigated. For this study, walking tract analysis, plantar test, western blot for COX-2 and TNF-${\alpha}$, and immunohistochemistry for neurofilament were performed. Results : In the present results, sciatic functional index(SFI) in walking tract analysis was significantly decreased following sciatic crushed nerve injury, and pain severity in plantar test was significantly increased. COX-2 and TNF-${\alpha}$ expressions were increased whereas neurofilament expression was decreased by sciatic crushed nerve injury. On the other hand, bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture improved SFI in walking tract analysis and suppressed the pain severity in sciatic crushed nerve injury. Bee venom pharmacopuncture and scolopendra subspinipes pharmacopuncture suppressed COX-2 and TNF-${\alpha}$ expression and enhanced the neurofilament expression in sciatic crushed nerve injury. Conclusions : In the present study, we have shown that treatment with bee venom or scolopendra subspinipes is the effective therapeutic modality to ameliorate the symptoms of sciatic crushed nerve injury. The efficacies of bee venom and scolopendra subspinipes were similar.

Effect of Exercise on Neurotrophins, BDNF, NT-3, GAP43 Protein Expression and Axonal Regeneration after Sciatic Nerve Injury in F344 Rats (운동이 좌골신경 손상 F344쥐의 Neurotrophins, BDNF, NT-3, GAP-43 단백질 발현과 축삭재생에 미치는 영향)

  • Yoon Jin-Hwan;Seo Tae-Beom
    • Journal of Life Science
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    • v.16 no.3 s.76
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    • pp.464-471
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    • 2006
  • Peripheral nerve injuries are a commonly encountered clinical problem and often result in severe functional deficits. In the present study, the effects of treadmill exercise on neurotrophin expressions and functional recovery following sciatic crushed nerve injury were investigated. Animals were randomly assigned into four groups: the sciatic nerve injury group, the sciatic nerve injury and 3-day-exercise, the sciatic nerve injury and 7-days-exercise, and the sciatic nerve injury and 14-days-exercise groups. Sciatic nerve injury was caused by crushing the right sciatic nerve for 30 s using a surgical clip. A the light-exercise was applied to each of the exercise group over the respective number of days. In the present results, we identified enhanced axonal re-growth in the distal stump of the sciatic nerve 3-14 days after crush injury with treadmill training. Dorsal root ganglion (DRG) neuron when cultured from animals with nerve injury and treadmill training showed more enhanced neurite outgrowth than that of sedentary animals. Nerve growth factor (NGF) protein levels in low-intensity treadmill training group were highly induced in the injured sciatic nerves 3, 7 and 14 days after injury compared with sedentary group, and brain-derived neurotrophin factor (BDNF) protein levels in treadmill exercise group were highly induced in the injured sciatic nerve 3 days after injury compared with sedentary group. Then, treadmill exercise increased neurotrophic factors induced in the regenerating nerves. We further demonstrate that motor functional recovery after sciatic nerve injury was promoted by treadmill exercise. Thus, the present data provide a new evidence that treadmill exercise enhanced neurotrophins expression and axonal regeneration after sciatic nerve injury in rats.