• Title/Summary/Keyword: peripheral nerve

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Altered Peripheral Nerve Excitability Properties in Acute and Subacute Supratentorial Ischemic Stroke (급성 및 아급성 천막상 허혈성 뇌졸중에서 발생하는 말초신경 흥분성 변화)

  • Seo, Jung Hwa;Ji, Ki Whan;Chung, Eun Joo;Kim, Sang Gin;Kim, Oeung Kyu;Paeing, Sung Hwa;Bae, Jong Seok
    • Annals of Clinical Neurophysiology
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    • v.14 no.2
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    • pp.64-71
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    • 2012
  • Background: It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) function by the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMN after UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability properties of the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitability test (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motor axons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during the acute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration-charge curve, parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and the recovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group, significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stage of stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in ('fanning in') of the TE was found. Conclusions: Our results suggest that supratentorial brain lesions can affect peripheral axonal excitability even during the early stage. The NET pattern probably suggests background membrane depolarization of LMNs. These features could be associated with trans-synaptic regulation of UMNs to LMNs as one of the "neural plasticity" mechanisms in acute brain injury.

Ultrasound Guided Nerve Block at Vertebra and Lower Extremity (초음파를 활용한 하지와 체간부위의 신경차단술)

  • Park, Hyeng-Kyu
    • Clinical Pain
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    • v.20 no.2
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    • pp.93-98
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    • 2021
  • The use of ultrasonography has recently been increasing in musculoskeletal diagnosis or intervention treatment. Ultrasound guided procedure offers a reliable alternative to fluoroscopy or computed tomography for lumbar medial branch block, facet joint block and peripheral nerves of lower extremity. Further, there is no exposure to radiation and additional equipment necessary for the protection against radiation is required. And ultrasound guided procedure needs smaller space than fluoroscopy guided procedure with real time images in the outpatient department. This article reviews ultrasound guided procedure at lumbar vertebra and peripheral nerves of lower extremity.

Vascular Changes by the Ice and Ultrasound Thermal Therapy (온냉 물리치료시 나타나는 혈관변화에 관한 실험적 연구)

  • 박희경;홍정표
    • Journal of Oral Medicine and Pain
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    • v.21 no.1
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    • pp.79-87
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    • 1996
  • The purpose of this study was to assess the vascular changes after thermophysical therapies using ice pack and ultrasound, investgate the mechanism of peripheral vasodilation by sympathetic nerve, and to observe the effects of the ergotamine to the thermophysical therapy. The author had used 16 healthy rabbits which were divided into 2 groups : with and without administration of ergotamine. Experimental animals were sacrificed 5, 10, 20 minutes after experiment, and were examined with gross and stereoscope of resin casting blood vessel models. The results were as follows : 1. Vasodilation was not remarkably found in the group with administration of egrotamine after thermophysical therapy. 2. Vasodilation was remarkably found in the group without administration of ergotamine after thermophysical therapy. 3. Vasodilation was increased in the group without administration of ergotamine, but not remarkably found in the group with administration of ergotamine in lapse of time 4. Thermophysical therapy was most effective to arterioles. Our data suggest that the dilation of peripheral blood vessels from thermophysical therapy was controlled by sympathetic nerve, because the blood vessels did not changed after administration of ergotamines which was a sympathetic nerve blocker.

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SCHWANNOMA DEVELOPED FROM TRIGEMINAL NERVE (삼차신경에 발생한 신경초종)

  • Lee, Deok-Won;Jee, Yu-Jin
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.34 no.5
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    • pp.578-581
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    • 2008
  • Schwannoma named neurinoma, peripheral glioma, perineural fibriblastoma and Neurilemmoma is a ectodermal benign neoplasm which originates from schwann cell or neuro axons. It usually develops in peripheral systems of sensory nerves of gastrointestinal tract, oral cavity, and bone. It occurs more frequently in soft tissue than hard tissue, and is extremely rare in intraoral area. We report a case of Schwannoma that showed large mass on buccal cheek with Rt. midfacial swelling, pain, tenderness to palpation and involvement with maxillary branch of trigeminal nerve. We present this case and review the literature.

Intraosseous Malignant Peripheral Nerve Sheath Tumor of Multiple Bones of the Midfoot: A Case Report (중족부에 발생한 다발성 악성 말초 신경초 종양 1예: 증례 보고)

  • Lee, Hyobeom;Kim, Gab-Lae;Kim, Donghyeon
    • Journal of Korean Foot and Ankle Society
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    • v.24 no.4
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    • pp.156-160
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    • 2020
  • Malignant peripheral nerve sheath tumors (MPNSTs) usually arise in soft tissues; they are rarely found in the bone. This paper reports a case of MPNST in the foot and ankle joint involving the distal tibia, talus, calcaneus, navicular, medial intermediate, and lateral cuneiform, cuboid, and 2nd to 4th metatarsal bone. Palliative treatment was performed. The authors encountered a patient with intraosseous MPNST of the midfoot who presented with nonspecific clinical and radiologic findings. This case shows that a high index of suspicion and a histopathology examination, including immunohistochemistry, will be necessary for an accurate diagnosis.

Superficial malignant peripheral nerve sheath tumor from recurrent neurofibroma in the abdominal wall of a patient without neurofibromatosis type 1

  • Jung, Chang Yeon;Bae, Jung Min;Choi, Joon Hyuk;Jung, Ki Hoon
    • Journal of Yeungnam Medical Science
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    • v.36 no.1
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    • pp.63-66
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    • 2019
  • Malignant peripheral nerve sheath tumor (MPNST) is rare, accounting for 5-10% of all soft tissue sarcomas. MPNST is characteristically aggressive and has a poor prognosis. Fifty percent of patients with MPNST have neurofibromatosis type 1 (NF1). NF-associated MPNST occurs more often at younger ages than sporadic MPNST, but the survival difference is controversial. Superficial MPNST from a recurrent neurofibroma is extremely rare and only a limited number of cases have been reported in the literature. Herein, we report an unusual case of superficial MPNST from a recurrent neurofibroma in a patient without NF1.

Photobiomodulation Therapy in Recovery of Peripheral Facial Nerve Damage

  • Choi, Ji Eun
    • Medical Lasers
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    • v.9 no.2
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    • pp.89-94
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    • 2020
  • Photobiomodulation (PBM) therapy has been investigated to enhance and accelerate the recovery of injured peripheral nerves. Based on the wide range of benefits of PBM therapy and its clinical relevance, this study reviewed the efficacy of PBM in injured facial nerves. The search was performed in the PubMed database to find relevant articles published over the last 10 years. Four animal studies, two randomized controlled studies, one case series, and five case reports were reviewed. Despite the various parameters, functional analysis showed that PBM therapy using near-infrared irradiation has beneficial effects on the recovery of the acute phase of the damaged facial nerve, especially when related to faster functional improvement. There were no reported adverse effects of PBM therapy.

Peripheral nerve blocks for acute trigeminal neuralgia involving maxillary and mandibular branches: a case report

  • Ricardo Luiz de Barreto Aranha;Renata Goncalves Resende;Fernando Antonio de Souza
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.23 no.6
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    • pp.357-362
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    • 2023
  • Trigeminal neuralgia (TN) is neuropathic pain that affects the trigeminal nerve branches. Facial pain experienced by patients with TN is typically intense and excruciating. The second and third branches (maxillary and mandibular) are commonly affected. This case report focuses on the potential treatment options for acute TN attacks involving these branches. The proposed approach involves extra-oral peripheral blocks using local anesthetics. Pain levels were measured using a visual numeric scale (VNS) with potential side effects and other relevant documented information. The patients showed responses from high pain levels to almost complete remission (from 8 to 2 and from 10 to 2 on the final VNS), with no significant side effects. This technique provides immediate pain relief and complements oral medications by offering comfort and confidence until the desired drug effect is achieved.

The Effects of c-Fos Expression on Ultrasound Treatment in Sciatic Nerve Crush Damaged Rats (초음파 치료가 좌골신경 압좌 손상된 흰쥐의 c-Fos 발현에 미치는 영향)

  • Kim, Dong-Dae
    • Journal of Korean Physical Therapy Science
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    • v.14 no.1_4
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    • pp.11-23
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    • 2007
  • This study was performed to evaluate the effects of low-intensity ultrasound application to the peripheral nerve injury animal model on enhancement of nerve regeneration and functional recovery. Using aseptic microsurgical techniques, the sciatic nerve of adult male Sprague-Dawley rats was crushed at the outside of right mid-thigh for 30 seconds with fine forceps. Beginning just after surgery, various continuous-wave ultrasound treatments with intensities of 0.2 W/$cm^2$, 0.5 W /$cm^2$ and 1.0 W /$cm^2$ operated at 1 MHz or sham treatment were applied to the opposite inside of the crush site for 1 minute every other day with a transducer moving speed of 2cm/sec. For evaluation of the progress of sciatic nerve regeneration, c-Fos expression in the lumbar spinal cord (L4-5) dorsal horn was investigated. c-fos expression was markedly increased at 1hour after sciatic nerve crush injury, then gradually decreased thereafter. The c-fos expressions were significantly decreased (p<0.05) in all the experimental groups in comparison with the control group until 3days post-crush, and the degrees of decrease were higher in 0.5 W/$cm^2$ and 1 W/$cm^2$ intensity ultrasound application groups. It is suggested that low-intensity ultrasound application to an animal model of sciatic crush injury may suppress pain transmission and promote nerve regeneration, and which may result in delayed progress of muscle atrophy and accelerated progress of muscle recovery and eventually may result in accelerated and improved foot function recovery.

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Improvement of PENS on Peripheral Nerve Conduction Function in STZ-Induced Diabetic Rats (당뇨유발백서에서 피하신경전기자극의 말초신경기능 개선효과)

  • Kim, Yang-Ho;Chang, Mee-Kyung;Shin, Min-Chul
    • The Journal of Korean Physical Therapy
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    • v.18 no.4
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    • pp.19-26
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    • 2006
  • Purpose: This study aimed the effects of percutaneous electric nerve stimulation (PENS) applied to different parts of the streptozotocin-induced diabetic rats on the change of glucose and nerve. Methods: rats (ten weeks old) were selected as the subjects; the normal group was five rats, and the diabetes induction group II, III and IV were five rats, respectively, which were randomly sampled from the twenty-five streptozotocin-administered rats with more than $240\;d{\ell}/m{\ell}$ of blood sugar. For PENS, electric current with 2 Hz of stimulation frequency and $200\;{\mu}s$ of pulse duration was applied to the subjects for fifteen minutes a day, six days a week, for three weeks. Calculation of glucose and weight, and nerve conduction test were conducted forty-eight hours and three weeks after streptozotocin administration, respectively. Results: As for change of glucose and weight, the group III with stimulation to the acupoints and the group IV with stimulation to non-acupoints showed significant differences from the control group II (p<0.05). As for MNCV (motor nerve conduction velocity), the group III with stimulation to the acupoints showed significant differences from the group IV with stimulation to non-acupoints and the control group II (p<0.05). Conclusion: PENS had the effects of inhibiting increase of glucose, change of weight and decrease of nerve conductive function between the distal and proximal ends of the peripheral nerve in the STZ-induced diabetic rats.

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