• Korean Journal of Clinical Laboratory Science
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• v.53 no.2
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• pp.151-157
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• 2021

Charcot-Marie-Tooth disease (CMT) is a slowly progressive hereditary degenerative disease and chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is an acquired immune-mediated disorder characterized by weakness and sensory deficits. The purpose of this study was to analyze and compare the electrophysiological characteristics observed in sensory nerve conduction studies (SNCS) of both diseases. A retrospective study of 65 patients with a diagnosis of CIDP (N=35) and CMT type I (N=30) was performed. This study analyzed No potentials ratio, distal compound nerve action potential (dCNAP) of various nerve types, and a correlation coefficient analysis of the sensory nerve conduction velocity (SNCV). As a result, I found that CMT 1 was more severe systemic demyelinating and axonal polyneuropathy better than CIDP (P<0.05). In a quantitative analysis of dCNAP and SNCV, especially sural nerve was the most severe nerve injury observed in both diseases. In correlation and scatter plot analysis, CMT 1 showed relatively high correlations compared to CIDP based on the correlation coefficient analysis (Fisher's Z test) of SNCV. The results of this study suggested that CMT 1 showed the slowness in SNCV, one of the characteristics of demyelinating polyneuropathy, and this slowing had a uniform pattern. In conclusion, electrophysiological characteristic of SNCS may be useful in the diagnosis and research between patients with CMT 1 and CIDP.

• 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.

• Annals of Clinical Neurophysiology
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• v.16 no.1
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• pp.21-26
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• 2014

Background: Electrophysiological study has been known as a useful method to evaluate the therapeutic effect of operation in idiopathic carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the clinical and electrophysiological changes after carpal tunnel release (CTR) compared to the preoperative results. Methods: We analyzed the changes of nerve conduction study (NCS) before and after minimal open carpal tunnel release in 18 patients (25 hands) with CTS. Follow-up study was performed over 6 months after operation. Results: Clinical improvement was seen in all cases after CTR. In contrast, electrophysiological improvement was various depending on the parameters; the mean median sensory latency and nerve conduction velocity (NCV) improved significantly (p = 0.001). The mean median motor latency also improved, but NCV and compound muscle action potential (CMAP) amplitude did not change. The extent of improvement was evident in moderate CTS, but not in severe CTS. Conclusions: In this preliminary study, all subjects who underwent CTR achieved a clinical relief along with a significant improvement of electrophysiological parameters such as median sensory latency, sensory NCV and median distal motor latency. After CTR, a number of cases with mild to moderate CTS showed a prominent improvement of clinical and electrophysiological parameters, while fewer improvements were seen in severe CTS, although it did not reach the statistical significance.

• Annals of Clinical Neurophysiology
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• v.10 no.1
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• pp.43-47
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• 2008

Background: Acute brachial plexitis is an acute idiopathic inflammatory disease affecting brachial plexus, which is characterized by initial severe pain in shoulder followed by profound weakness of affected arm. This is a retrospective study to evaluate the clinical and electrophysiological profile of acute brachial plexitis. Methods: Sixteen patients with acute brachial plexitis were sampled. The electrodiagnostic studies included motor and sensory nerve conduction studies (NCSs) of the median and ulnar, sensory NCSs of medial and lateral antebrachial cutaneous nerves, and needle electromyography (EMG) of selected muscles of upper extremities and cervical paraspinal muscles. The studies were performed on both sides irrespective of the clinical involvement. Results: In most of our patient, upper trunk was predominantly affected (14 patients, 87.50%). Only two patients showed either predominant lower trunk affection or diffuse affection of brachial plexus. All had an acute pain followed by the development of muscle weakness of shoulder girdle after a variable interval ($7{\pm}8.95$ days). Ten patients (62.50%) had severe disability. In NCSs, the most frequent abnormality was abnormal lateral antebrachial cutaneous sensory nerve action potentials (SNAPs). On needle EMG, all the patients showed abnormal EMG findings in affected muscles. Conclusions: In this study, pain was the presenting feature in all patients, and the territory innervated by upper trunk of the brachial plexus was most frequently involved. The most common NCS abnormality was abnormal SNAP in lateral antebrachial cutaneous nerve. Our findings support that the electrodiagnostic test is useful in localizing the trunk involvement in acute brachial plexitis.

• Journal of Medicine and Life Science
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• v.21 no.1
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• pp.11-14
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• 2024

Excess of pyridoxine, in contrast to other nutrients, may result in neuropathy. Case reports are sparse, and little is known about the clinical and electrophysiological findings. Eight patients with pyridoxine-induced neuropathy were investigated, and a review of the literature was undertaken. Nerve conduction studies showed axonal sensory or sensorimotor polyneuropathy. And the blood levels of vitamin B6 were markedly elevated. After discontinuation of vitamin supplements, all patients showed no significant improvement in clinical and electrophysiological findings. Supplementation with pyridoxine at doses greater than 50 mg/day for extended durations may be harmful and should be discouraged.

• Journal of the Korean Academy of Clinical Electrophysiology
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• v.4 no.1
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• pp.63-83
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• 2006

This study conducted the following experiment to examine anesthetic effects of 500 kHz ultrasound with lidocaine. Clinical experiment was conducted to compare local anesthetic effects by ultrasound frequencies and drugs with 40 normal adults and it divided subjects into experimental group (I) applying only ultrasound, ointment group (II) applying only lidocaine, phonophoresis group of 1 MHz (III), phonophoresis group of 500 kHz lidocaine (IV) for pain threshold and nerve conduct experiments. Mechanical threshold was measured with von Frey monofilament, thermal pain threshold with halogen lamp and digital thermometer, action potential in median nerve with diagnostic electromyography before and after treatment, and at 30 min., 60 min., 90 min., and 120 min. after treatment. Results of this study can be summarized as follows. Topical anesthesia experiment showed that pain threshold of phonophoresis groups was significantly increased, but there were little differences in ultrasound frequency and drugs among phonophoresis groups. Conduction anesthesia experiment showed that phonophoresis group of 500 kHz using lidocaine had significant difference in pain threshold and sensory nerve conduction compared to ointment group and ultrasound group, but there was no great difference from other phonophresis groups and light nerve block effect was found. It was considered that application of 500 kHz ultrasound using lidocaine will be more effective in deep anesthesia or nerve block than 1 MHz ultrasound. However, researches considering various frequencies, intensities and application hours in low frequency areas including kHz ultrasound are needed to increase deep permeation of drugs.

• Diabetes and Metabolism Journal
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• v.42 no.6
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• pp.519-528
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• 2018

Background: Clinical manifestations of diabetic peripheral neuropathy (DPN) vary along the course of nerve damage. Nerve conduction studies (NCS) have been suggested as a way to confirm diagnoses of DPN, but the results have limited utility for evaluating clinical phenotypes. The current perception threshold (CPT) is a complementary method for diagnosing DPN and assessing DPN symptoms. We compared NCS variables according to clinical phenotypes determined by CPT measurements. Methods: We retrospectively enrolled patients with type 2 diabetes mellitus who underwent both NCS and CPT tests using a neurometer. CPT grades were used to determine the clinical phenotypes of DPN: normoesthesia (0 to 1.66), hyperesthesia (1.67 to 6.62), and hypoesthesia/anesthesia (6.63 to 12.0). The Michigan Neuropathy Screening Instrument (MNSI) was used to determine a subjective symptom score. DPN was diagnosed based on both patient symptoms (MNSI score ${\geq}3$) and abnormal NCS results. Results: A total of 202 patients (117 men and 85 women) were included in the final analysis. The average age was 62.6 years, and 71 patients (35.1%) were diagnosed with DPN. The CPT variables correlated with MNSI scores and NCS variables in patients with diabetes. Linear regression analyses indicated that hypoesthesia was associated with significantly lower summed velocities and sural amplitudes and velocities, and higher summed latencies, than normoesthesia. Sural amplitude was significantly lower in patients with hyperesthesia than in patients with normoesthesia. Conclusion: NCS variables differed among patients with diabetes according to clinical phenotypes based on CPT and decreased sural nerve velocities was associated with hyperesthesia.

• 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.

• Archives of Plastic Surgery
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• v.37 no.5
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• pp.676-680
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• 2010

Purpose: Median nerve entrapment syndrome within carpal tunnel is usually called carpal tunnel syndrome and it is the most common form of peripheral nerve entrapment syndrome. Many factors such as diabetes mellitus, hypothyroidism, hormonal replacement theraphy, corticosteroid use, rhematoid arthritis and wrist fractures may cause carpal tunnel syndrome. To the best of our knowledge, this is the first case report of median nerve entrapment syndrome due to adhesion of laceration wound after suicidal attempt. Methods: A 28-year-old woman presented with a sensory change and thenar hypotrophy on her left hand. On her history, she attempted suicide by slashing her wrist. Initial electromyography (EMG) showed that the nerve conduction velocities of median nerve was delayed. Therefore, we performed surgical procedures. When exploration, Fibrous scar tissue observed around the median nerve but nerve had not been injured. Transcarpal ligament was completely released and adjacent fibrous tissue was removed to decompress the median nerve. Results: The postoperative course was uneventful until the first year. Opposition difficulty and thenar hypotrophy were improved progressively after the surgery. Sensory abnormality was slowly improved over one year. Conclusion: We report a case of median nerve entrapment syndrome that was caused by adhesion of laceration wound after suicidal attempt. This is an unusual cause of median nerve entrapment syndrome, the symptoms were relieved after transcarpal ligament release and fibrous scar tissue removal.

• PNF and Movement
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• v.19 no.2
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• pp.195-203
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• 2021

Purpose: Neurodynamic tests are used to examine neural tissue in patients with neuro-musculoskeletal disorders, although this has not yet been established in the intensity of nerve tension application. This study aimed to investigate the acute effects of neural stretching intensity on nerve excitability using the latency and amplitude of nerve conduction velocity test (NCV) analysis. Methods: Thirty young, healthy male and female subjects (mean age = 21.30 years) voluntarily participated in this study. Nerve excitability was assessed using the median sensory NCV test. The latency and amplitude of the NCV test were measured under four different conditions: reference phase (supra-maximal stimulus, without neural stretching), baseline phase (2/3 of the supra-maximal stimulus, without neural stretching), weak stretch phase (2/3 of the supra-maximal stimulus, with weak neural stretching), and strong stretch phase (2/3 of the supra-maximal stimulus, with strong neural stretching). Results: The NCV latency was significantly delayed after one minute of neural stretching at the baseline, weak phase, and strong phase in comparison with the reference phase. The NCV latency was significantly delayed by increasing the strength of neural stretching. Furthermore, the NCV amplitude was significantly increased at the weak and strong phases, which were under neural stretching, in comparison with the baseline phase. The NCV amplitude was significantly increased by increasing the strength of the neural stretching. Conclusion: Transient neural stretching as a neurodynamic test can increase the sensitivity of the nerve without negatively affecting the nervous system. However, based on the results of this study, strong neural stretching in the neurodynamic test may delay the transmission of nerve impulses and hypersensitivity.