• Title/Summary/Keyword: nerve

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The relationship between nerve conduction studies and neuropathic pain in sciatic nerve injury due to intramuscular injection

  • Fidanci, Halit;Ozturk, Ilker
    • The Korean Journal of Pain
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    • v.34 no.1
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    • pp.124-131
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    • 2021
  • Background: Sciatic nerve injury due to intramuscular injection (SNIII) is still a health problem. This study aimed to determine whether there is a correlation between neuropathic pain and electrodiagnostic findings in SNIII. Methods: Patients whose clinical and electrodiagnostic findings were compatible with SNIII participated in this retrospective cohort study. Compound muscle action potential (CMAP) and sensory nerve action potential (SNAP) amplitudes of the sural, superficial peroneal, peroneal, and tibial nerves were graded from 1 to 4. Leeds assessment of neuropathic symptoms and signs scale (LANSS) was applied to all patients. Results: Forty-eight patients were included in the study, 67% of whom had a LANSS score ≥ 12. Sural SNAP amplitude abnormalities were present in 8 (50%) out of 16 patients with a LANSS score < 12, and 28 (87.5%) out of 32 patients with a LANSS score ≥ 12, with significant differences between the groups (P = 0.011). There was a positive correlation between the LANSS score and the sural SNAP amplitude grading (P = 0.001, r = 0.476). A similar positive correlation was also found in the LANSS score and the tibial nerve CMAP amplitude grading (P = 0.004, r = 0.410). Conclusions: This study showed a positive correlation between the severity of tibial nerve CMAP/sural SNAP amplitude abnormality and LANSS score in SNIII. Neuropathic pain may be more common in SNIII patients with sural nerve SNAP amplitude abnormality.

Ultrasonography-Combined with Nerve Stimulator Technique for Injection of the Genitofemoral Nerve in a Patient with Chronic Postoperative Inguinal Pain (수술 후 서혜부 만성 통증에서 신경 자극기를 이용한 초음파 유도하 음부대퇴신경 차단술)

  • Oh, Young-Bin;Shin, Hyun Baek;Ko, Myoung-Hwan;Seo, Jeong-Hwan;Kim, Gi-Wook
    • Clinical Pain
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    • v.18 no.1
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    • pp.36-39
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    • 2019
  • Chronic postoperative inguinal pain (CPIP) is a major complication after inguinal herniorrhaphy. We report the treatment of CPIP using ultrasonography-combined with nerve stimulator for injection of the genitofemoral nerve (GFN). A 59-year-old man underwent laparoscopic herniorrhaphy and presented with numbness from the inguinal region to the scrotum after operation. In the pain clinic, ultrasonography-guided GFN block and pharmacological treatments had little effect. Six month after operation, patient was referred to the Department of Physical Medicine and Rehabilitation, and ultrasonography-combined with nerve stimulator for GFN injection underwent to enhance the accuracy of neural approach. The induction of scrotal contraction and paresthesia on the GFN distribution was monitored by nerve stimulator and local anesthetic was injected. After the block, pain relief lasted for 6 months without analgesic use. Ultrasonography-combined with nerve stimulator is an effective approach to treat CPIP as it enhances precise localization and injection of small peripheral nerve like GFN.

Fascicular Involvement of the Median Nerve Trunk in the Upper Arm: Manifestation as Anterior Interosseous Nerve Syndrome With Unique Imaging Features

  • Jae Eun Park;Darryl B. Sneag;Yun Sun Choi;Sung Hoon Oh;SeongJu Choi
    • Korean Journal of Radiology
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    • v.25 no.5
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    • pp.449-458
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    • 2024
  • Selective fascicular involvement of the median nerve trunk above the elbow leading to anterior interosseous nerve (AIN) syndrome is a rare form of peripheral neuropathy. This condition has recently garnered increased attention within the medical community owing to advancements in imaging techniques and a growing number of reported cases. In this article, we explore the topographical anatomy of the median nerve trunk and the clinical features associated with AIN palsy. Our focus extends to unique manifestations captured through MRI and ultrasonography (US) studies, highlighting noteworthy findings, such as nerve fascicle swelling, incomplete constrictions, hourglass-like constrictions, and torsions, particularly in the posterior/posteromedial region of the median nerve. Surgical observations have further enhanced the understanding of this complex neuropathic condition. High-resolution MRI not only reveals denervation changes in the AIN and median nerve territories but also illuminates these alterations without the presence of compressing structures. The pivotal roles of high-resolution MRI and US in diagnosing this condition and guiding the formulation of an optimal treatment strategy are emphasized.

Skin biopsy: an emerging method for small nerve fiber evaluation

  • Sohn, Eun Hee
    • Annals of Clinical Neurophysiology
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    • v.20 no.1
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    • pp.3-11
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    • 2018
  • Skin biopsy and staining the specimens with immuno-reactive markers has been proven to be a useful method to demonstrate the pathologic status of small nerve fibers. Quantification of intraepidermal nerve fiber density using anti-protein gene product 9.5 antibody is a standard method to diagnose small fiber neuropathy. Skin biopsy also makes it possible to differentiate the nerve fibers according to their function by using different markers. Quantification of dermal structures with different types of nerve fibers could reveal the pathophysiologic mechanism of the disease state.

Stimulus Artifact Suppression on the type of Nerve Stimulator (신경자극기 형태에 따른 자극 Artifact 제거 방법에 대한 연구)

  • 유세근;민병관
    • Journal of Biomedical Engineering Research
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    • v.14 no.3
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    • pp.251-256
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    • 1993
  • The conduction velocity of the nerve is of importance to the diagnosis of various negromuscular disorders. A major technical problem encountered in nerve stimulation technique is the control of stimulus artifact and the convenience of nerve stimulator. The remained artifacts must be removed by processing the contaminated signal. This paper discusses about the artifact cancellation algorithms in constant voltage type nerve stimulator(CVS) and constant current type nerve stimulator(CCS).

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Neurogenic pathways in remote ischemic preconditioning induced cardioprotection: Evidences and possible mechanisms

  • Aulakh, Amritpal Singh;Randhawa, Puneet Kaur;Singh, Nirmal;Jaggi, Amteshwar Singh
    • The Korean Journal of Physiology and Pharmacology
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    • v.21 no.2
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    • pp.145-152
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    • 2017
  • Remote ischemic preconditioning (RIPC) is an intrinsic phenomenon whereby 3~4 consecutive ischemia-reperfusion cycles to a remote tissue (non-cardiac) increases the tolerance of the myocardium to sustained ischemia-reperfusion induced injury. Remote ischemic preconditioning induces the local release of chemical mediators which activate the sensory nerve endings to convey signals to the brain. The latter consequently stimulates the efferent nerve endings innervating the myocardium to induce cardioprotection. Indeed, RIPC-induced cardioprotective effects are reliant on the presence of intact neuronal pathways, which has been confirmed using nerve resection of nerves including femoral nerve, vagus nerve, and sciatic nerve. The involvement of neurogenic signaling has been further substantiated using various pharmacological modulators including hexamethonium and trimetaphan. The present review focuses on the potential involvement of neurogenic pathways in mediating remote ischemic preconditioning-induced cardioprotection.

A Case of the Oculomotor Nerve Palsy in Benedikt's Syndrome (베네딕트(Benedikt) 증후군의 동안신경마비에 대한 한방치험 1례)

  • 정은정;양대진;정기현;노진환;문상관;조기호
    • The Journal of Korean Medicine
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    • v.21 no.3
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    • pp.225-230
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    • 2000
  • In a complete oculomotor nerve palsy, patients show ptosis(paresis of the levator), abduction(paresis of the medial rectus and compensatory overaction of the lateral rectus) and dilated pupils. In oculomotor nerve palsy, the functions of four of the six extraocular muscles are compromised and its treatment is the most difficult problem in the paralytic strabismus. Currently, if the condition of the oculomotor nerve palsy is not improved within a year, surgical correction can be attempted. We experienced an improved case of the oculomotor nerve palsy in a Benedikt's syndrome patient treated with oriental medicine. We used herbal medicine and acupuncture. Based on this experience, it is considered that oriental medicine can be applied to the treatment of the oculomotor nerve palsy. Oculomotor nerve, Palsy, Ptosis, Abduction, Benedikt's syndrome.

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Suprascapular Nerve Entrapment by Ganglion Cyst - 2 Cases Report - (결절종에 의한 상겹갑 신경 포착 신경병증 -2례 보고-)

  • Kyung Hee-Soo;Kim Sung-Jung;Kim Poong-Taek;Kim Young-Woo
    • Clinics in Shoulder and Elbow
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    • v.3 no.2
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    • pp.109-114
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    • 2000
  • Ganglion cysts causing suprascapular nerve compression are uncommon cause of suprascapular nerve entrapment. The advent of magnetic resonance imaging and its application in patients with shoulder pain has improved the ability to diagnose cystic lesions causing extrinsic compression of the suprascapular nerve. We present two cases of suprascapular nerve compression by ganglion cyst which was decompressed by surgical excision. Suprascapular nerve compression was also revealed by magnetic resonance imaging(MRI), electromyogram(EMG) and clinical present of muscle atrophy and motor weakness. In each case, the symptom was resolved after sugical excision of the cystic lesion. We experienced two cases of suprascapular nerve entrapment by ganglion cyst and report the clinical, radiological and pathological findings in detail.

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Usefulness of Ultrasound for Detecting Suspected Peripheral Nerve Lesions in Diagnosis of Peripheral Neuropathy : Case Report and Brief Review of the Literature

  • Jung, Jae-Hyun;Kim, Kwang-Hai;Choi, Soon-Kyoo;Shim, Jae-Hyun
    • Journal of Korean Neurosurgical Society
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    • v.53 no.2
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    • pp.132-135
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    • 2013
  • Ultrasound scanning of a peripheral nerve along its expected course is a simple and useful method for determining the cause of peripheral neuropathy. We present 3 cases of peripheral neuropathy in which the pathology was detected by simple ultrasound scanning of the affected nerve. There were 2 cases of entrapment neuropathy due to mucoid cyst and 1 case of nerve sheath tumor. All lesions were visualized by simple ultrasound scanning of the involved peripheral nerve. Our results suggest that if a lesion affecting the peripheral nerve is suspected after history and physical examination or electrophysiologic studies, ultrasound scanning of the peripheral nerve of interest throughout its course is very helpful for identifying the causative lesion.

Pituitary Apoplexy Presenting as Isolated Oculomotor Nerve Palsy

  • Yang, Moon-Seok;Cho, Won-Ho;Cha, Seung-Heon
    • Journal of Korean Neurosurgical Society
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    • v.41 no.4
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    • pp.246-247
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    • 2007
  • The most common cause of isolated oculomotor nerve palsy is ischemia of the peripheral nerve caused by a disease, such as diabetes mellitus. Another common cause of isolated oculomotor nerve palsy is compression by an intracranial aneurysm, usually an posterior communicating artery aneurysm. However, it is extremely rare in the pituitary tumor. We report an unusual case of pituitary adenoma presenting with isolated oculomotor nerve palsy in the setting of pituitary apoplexy. We suggest that pituitary apoplexy should be included in the differential diagnosis of a patient with isolated oculomotor nerve palsy and early surgery should be considered for preservation of oculomotor nerve function.