• Journal of Yeungnam Medical Science
• /
• v.6 no.1
• /
• pp.151-163
• /
• 1989

Nerve conduction studies help delineate the extent and distribution of the neural lesion. The nerve conduction was studied on upper(median, ulnar and radial nerves) and lower(personal, posterior tibial and sural nerves) extremities in 83 healthy subjects 23 to 66 years of age. and normal values were established(Table 1). The mean motor terminal latency (TL) were : median. 3.6(${\pm}0.6$)milliseconds ; ulnar. 2.9(${\pm}0.5$) milliseconds ; radial nerve. 2.3(${\pm}0.4$) milliseconds. Mean motor nerve conduction velocity(MNCV) along distal and proximal segments: median. 61.2(${\pm}9.1$) (W-E) and 57.8(${\pm}13.2$) (E-Ax) meters per second ; ulnar. 63.7(${\pm}9.1$) (W-E) and 50.(${\pm}10.0$) meters per second. Mean sensory nerve conduction velocity(SNCV) : median. 34.7(${\pm}6.7$) (F-W), 63.7(${\pm}7.1$) (W-E) and 62.8(${\pm}12.3$) (E-Ax)meters per second ; ulnar. 38.0(${\pm}6.7$)(F-W), 63.4(${\pm}7.5$) (W-E) and 57.0(${\pm}10.1$) (E-Ax)meters per second ; radial, 45.3(${\pm}6.8$) (F-W) and 64.2(${\pm}11.0$) (W-E) meters per second ; sural nerve, 43.4(${\pm}6.1$) meters per second. The amplitudes of action potential and H-reflex were also standardized. Mean H latency was 28.4(${\pm}3.2$) milliseconds. And. the fundamental principles, several factors altering the rate of nerve conduction and clinical application of nerve stimulation techniques were reviewed.

• Physical Therapy Korea
• /
• v.21 no.4
• /
• pp.1-8
• /
• 2014

Transcranial direct current stimulation (tDCS) is a neuromodulatory technique that delivers low-intensity direct current to cortical areas, thereby facilitating or inhibiting spontaneous neuronal activity. This study was designed to investigate changes in various sensory functions after tDCS. We conducted a single-center, single-blinded, randomized trial to determine the effect of a single session of tDCS with the current perception threshold (CPT) in 50 healthy volunteers. Nerve conduction studies were performed in relation to the median sensory and motor nerves on the dominant hand to discriminate peripheral nerve lesions. The subjects received anodal tDCS with 1 mA for 15 minutes under two different conditions, with 25 subjects in each groups: the conditions were as follows tDCS on the primary motor cortex (M1) and sham tDCS on M1. We recorded the parameters of the CPT a with Neurometer$^{(R)}$ at frequencies of 2000, 250, and 5 Hz in the dominant index finger to assess the tactile sense, fast pain and slow pain, respectively. In the test to measure CPT values of the M1 in the tDCS group, the values of the distal part of the distal interphalangeal joint of the second finger statistically increased in all of 2000 Hz (p=.000), 250 Hz (p=.002), and 5 Hz (p=.008). However, the values of the sham tDCS group decreased in all of 2000 Hz (p=.285), 250 Hz (p=.552), and 5 Hz (p=.062), and were not statistically significant. These results show that M1 anodal tDCS can modulate sensory perception and pain thresholds in healthy adult volunteers. The study suggests that tDCS may be a useful strategy for treating central neurogenic pain in rehabilitation medicine.

• Journal of Genetic Medicine
• /
• v.15 no.2
• /
• pp.107-109
• /
• 2018

X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is caused by the mutation in GJB1 gene, characterized by the transient central nervous system involvement and long standing peripheral polyneuropathy which does not fulfill the criteria of demyelination or axonopathy. We describe a 37-year-old man with progressive bilateral leg weakness since his early teen. He suffered transient right hemiparesis, followed by quadriparesis at 14 years of age. When we examined him at 37 years of age, he presented a distal muscle weakness on lower extremities with a sensory symptom. The nerve conduction study demonstrated a motor conduction velocity between 26 and 49 m/s. The whole exome sequencing revealed a novel variant c.136 G>A in GJB1. This report will raise awareness in this rare disease, which is frequently misdiagnosed early in its course.

• Annals of Clinical Neurophysiology
• /
• v.2 no.1
• /
• pp.21-26
• /
• 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.

• Journal of Korean Neurosurgical Society
• /
• v.52 no.3
• /
• pp.267-269
• /
• 2012

Traumatic brachial plexus injuries can be devastating, causing partial to total denervation of the muscles of the upper extremities. Surgical reconstruction can restore motor and/or sensory function following nerve injuries. Direct nerve-to-nerve transfers can provide a closer nerve source to the target muscle, thereby enhancing the quality and rate of recovery. Restoration of elbow flexion is the primary goal for patients with brachial plexus injuries. A 4-year-old right-hand-dominant male sustained a fracture of the left scapula in a car accident. He was treated conservatively. After the accident, he presented with motor weakness of the left upper extremity. Shoulder abduction was grade 3 and elbow flexor was grade 0. Hand function was intact. Nerve conduction studies and an electromyogram were performed, which revealed left lateral and posterior cord brachial plexopathy with axonotmesis. He was admitted to Rehabilitation Medicine and treated. However, marked neurological dysfunction in the left upper extremity was still observed. Six months after trauma, under general anesthesia with the patient in the supine position, the brachial plexus was explored through infraclavicular and supraclavicular incisions. Each terminal branch was confirmed by electrophysiology. Avulsion of the C5 roots and absence of usable stump proximally were confirmed intraoperatively. Under a microscope, neurotization from the musculocutaneous nerve to two medial pectoral nerves was performed with nylon 8-0. Physical treatment and electrostimulation started 2 weeks postoperatively. At a 3-month postoperative visit, evidence of reinnervation of the elbow flexors was observed. At his last follow-up, 2 years following trauma, the patient had recovered Medical Research Council (MRC) grade 4+ elbow flexors. We propose that neurotization from medial pectoral nerves to musculocutaneous nerve can be used successfully to restore elbow flexion in patients with brachial plexus injuries.

• Journal of Genetic Medicine
• /
• v.18 no.2
• /
• pp.83-93
• /
• 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.

• Annals of Clinical Neurophysiology
• /
• v.24 no.1
• /
• pp.1-6
• /
• 2022

Small fiber neuropathy is a painful neuropathy that cannot be assessed using nerve conduction studies. A skin biopsy and quantitative sensory testing (QST) are the gold standards for small fiber neuropathy diagnosis. However, a skin biopsy is invasive and commercially unavailable in Korea. QST is a method involving a thermal threshold, but its results can be affected by cognition as well as lesions of the central nervous system. Quantitative sudomotor axon reflex test (QSART) is a quantitative method of assessing sweat glands innervated by small fibers. In this review, we assessed the utility of QSART in evaluating small fiber neuropathy.

• Journal of Oral Medicine and Pain
• /
• v.35 no.1
• /
• pp.93-99
• /
• 2010

Herpes zoster (HZ) is the secondary manifestation of an earlier infection with the varicella-zoster virus in one or more dermatomes. As reactivation of the virus is linked to an age-related diminished virus-specific and cell-mediated immunity, HZ develops mainly in elderly people. Acute zoster is painful, but does not incur lasting morbidity. Reactivation of the varicella-zoster virus in the trigeminal nerve (Herpes zoster) occur with severe pain and rash in the oro-facial region. The acute pain decreases as the rash begins to heal. Postherpetic neuralgia(PHN), the most frequent complication of herpes zoster, is usually defined as pain in the involved dermatome that is still present 3 month after rash onset. The clinical characteristics of PHN are, eposodic stabbing pain, burning pain and allodynia, with hypoesthesia and/or dysesthesia. $Neurometer^{(R)}$(neuroselective sensory nerve conduction threshold: sNCT, Automated current perception threshold: CPT, neurotron incorporated. Baltimore, Maryland. 21209 U.S.A.) is convenient, rapid and noninvasive, and allows objective assessment of sensory disturbance. This case is about the postherptic neuralgia patient assessed with $Neurometer^{(R)}$. From this case, we reviewed the pathophysiology and the treatment of PHN and recommend the assessment of pain intensity with $Neurometer^{(R)}$ as quantitative and objective method.

• Annals of Clinical Neurophysiology
• /
• v.7 no.2
• /
• pp.133-137
• /
• 2005

Underlying neuropathies combined with amyotrophic lateral sclerosis (ALS) cast doubt on the diagnosis of ALS when present. Abnormal sural nerve conductions were found in 3 patients with clinically definite ALS. Pathologically demyelinating, axonal, or vasculitic neuropathy was suggested respectively. High dose oral corticosteroid had no effect and clinical courses were deteriorating in all the patients. The causes of combined neuropathies were unclear. Possibility of direct consequence of ALS, concomitant neuropathies, or rare variants of ALS should be considered in these cases.

• Archives of Plastic Surgery
• /
• v.37 no.1
• /
• pp.95-98
• /
• 2010

Purpose: One of the most common cause of upper extremity lymphedema is breast cancer surgery. We experienced the nerve entrapment syndrome which was associated with postmastectomy lymphedema. To the best of our knowledge, this is the first case report of lymphedema induced nerve entrapment syndrome on upper extremity in Korea. Methods: A 54-year-old woman presented with a tingling sensation on her right hand, which had been present for 1 year. On her history, she had a postmastectomy lymphedema on her right upper extremity for 20 years. Initial electromyography (EMG) showed that the ampulitude of the median, ulnar, and dorsal ulnar cutaneous nerve were decreased, and conduction block was also seen in median nerve across the wrist. In needle EMG, incomplete interference patterns were observed in the muscles innervated by median and ulnar nerves. In conclusion, electrophysiologic study and clinical findings suggested right median and ulnar neuropathy below the elbow. Therefore, we performed surgical procedures, which were release of carpal tunnel, Guyon's canal, and cubital tunnel. Results: The postoperative course was uneventful until the first two years. The tingling sensation and claw hand deformity were improved, however, the motor function decreased progressively. In 7 years after the operation, patient could not flex her wrist and thumb sufficiently. EMG which was performed recently showed that ulnar motor response was of low ampulitude. Moreover, median, ulnar, dorsal ulnar cutaneous, lateral antecubital cutaneous and median antebrachial cutaneous sensory response were unobtainable. Abnormal spontaneous activities were observed in upper arm muscles. In conclusion, multiple neuropathies were eventually developed at above elbow level. Conclusion: On treating nerve entrapments associated with lymphedema, medical professionals should be fully aware of the possibility of unpredictable results after the surgery, because of the pathophysiologic traits of chronic lymphedema.