• Title/Summary/Keyword: Electrophysiological study

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Temporal Relationship between Symptomatic and Electrophysiological Improvement to Postoperative Carpal Tunnel Syndrome Patients: Preliminary study (수근관 증후군 환자의 수술 후 증상 호전과 전기생리학적 호전시기의 관련성에 관한 예비연구)

  • Ko, Yeong-Chae;Lee, Yeong-Bae;Kim, Yoon-Bong;Yoo, Chan-Jong;Shin, Won-Chul;Park, Hyeon-Mi;Ha, Kyung-Sik;Shin, Dong-Jin
    • Annals of Clinical Neurophysiology
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    • v.5 no.2
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    • pp.177-180
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    • 2003
  • Background and Objectives: A nerve conduction study (NCS) has been known as a useful method to evaluate the therapeutic effect of operation in carpal tunnel syndrome (CTS). To evaluate the temporal relationship between symptomatic and electrophysiological improvement, we compared the preoperative symptoms and electrophysiological results with postoperative those. Methods: We analyzed the NCS changes before and after minimal release of carpal tunnel in 26 patients (34 hands) with CTS. The time of postoperative symptomatic changes, postoperative electrophysiological changes and temporal relationship between symptomatic and electrophysiological changes were evaluated. Results: The mean age was $49{\pm}13$ years. The proportion of males to female was 8 and 92 percent. The median interval days between date of operation and those of postoperative NCS was 28.5 days. Postoperative symptoms improved in 17 hands, slightly improved in 13 hands, and have not changed in 4 hands. Electrophysiological improvements after operation were observed in 26 hands, and mostly appeared within 2 months. Symptomatic relief accompanied with electrophysiological improvement reported in 13 hands (50%). Moreover, the four hands with symptom, not relieved by decompression, showed electrophysiological improvement. Conclusions: In this study, electrophysiological improvement was in consistency with symptomatic relief to some extent, but we got the result of disagreement between electrophysiological and symptomatic improvement.

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Clinical and Electrophysiological Changes after Open Carpal Tunnel Release: Preliminary Study of 25 Hands (수근관증후군 수술 전후 임상증상과 전기생리학적 검사소견의 변화: 25손을 대상으로 한 예비연구)

  • Yang, Ji Won;Sung, Young Hee;Park, Kee Hyung;Lee, Yeong Bae;Shin, Dong Jin;Park, Hyeon Mi
    • 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.

Clinical and Electrophysiological Changes after Local Steroid Injection in the Carpal Tunnel Syndrome (수근관증후군에서 국소 스테로이드 주사 후 임상적, 전기생리학적 변화)

  • Kim, Jihoon;Lee, Kee Ook;Yoon, Bora;Kim, Yong-Duk;Jung, Un Suk;Na, Sang-Jun
    • Annals of Clinical Neurophysiology
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    • v.15 no.1
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    • pp.7-12
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    • 2013
  • Background: Local steroid injection is used to treat carpal tunnel syndrome (CTS). The aim of this study was to evaluate the clinical and electrophysiological effects of local steroid injection in patients with CTS over a 3-months period. Methods: Twenty-one patients (35 hands) with clinical and electrophysiological evidence of CTS were treated by injection of triamcinolone 40 mg to the carpal tunnel. Visual analog scale (VAS), Boston Carpal Tunnel Questionnaire (BCTQ), rates of paresthesia, night awakening, and electrophysiological studies were used as outcomes. Clinical and electrophysiological assessments were performed before, 1 and 3 months after treatment. Results: Prior to treatment, 86% of patients complained of night awakening. At 1 and 3 months after injection, only 17% and 29% of the patients, respectively, had night awakening (p<0.001). All patients complained of paresthesia before the treatment. This symptom disappeared in 60% and 31% of the patients after 1 and 3 months, respectively (p<0.001). Compared to baseline, both BCTQ and VAS show significant improvement during the 3 months of the study (p<0.005). Although significant improvements in clinical parameters were shown, electrophysiological parameters were not significantly improved at 1 and 3 months. Conclusions: Local corticosteroid injection for the treatment of CTS provides significant improvement in symptoms for 3 months. On the other hand, no significant improvement was observed in electrophysiological parameters.

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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Endoscopic Release of Carpal Tunnel Syndrome; Temporal Correlation between Symptomatic and Electrophysiologicallmprovements in Postoperative Carpal Tunnel Syndrome

  • Park, Jin-Soo;Yoo, Chan-Jong;Chun, Young-Il;Kim, Woo-Kyung;Lee, Sang-Gu;Park, Cheol-Wan
    • Journal of Korean Neurosurgical Society
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    • v.37 no.1
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    • pp.8-15
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    • 2005
  • Objective: We evaluate temporal correlations between postoperative symptomatic and electrophysiological improvements, and assessed the recovery time required for patients with carpal tunnel syndrome(CTS) before returning to routine activities. Methods: 30 CTS patients were treated via the endoscopic monoportal approach, from March 2001 to September 2003. We assessed the symptoms (hyperesthesia in the finger tips, or abnormal sensations and painful numbness or night pain) and electrophysiological changes in the preoperative state, 1 month and 6 months after surgery. We marked the times at which patients became able to return to activities of daily living and work, after undergoing endoscopic carpal tunnel release. Results: At the end of the follow-up period, high levels of achievement and good outcomes were observed, with respect to both the symptoms and electrophysiological studies. We discovered significant differences between the preoperative and postoperative periods, especially in terms of motor nerve onset latency from $4.50{\pm}1.43$ to $3.97{\pm}0.69$ and sensory nerve conduction velocity, the wrist-to-finger from $19.81{\pm}10.03$ to $28.18{\pm}11.01$ and wrist-to-palm from $23.34{\pm}13.40$ to $31.79{\pm}13.38$(P<0.05 for each comparison). The average time interval required before return to activities of daily living was 26.4 days, and time interval required before return to work was 48.08 days. Conclusion: Electrophysiological improvements are largely consistent with symptomatic relief, but there is some disparity between electrophysiological and symptomatic improvement.

Electrophysiological features and prognosis of peripheral neuropathy associated with IgM monoclonal gammopathy: a single-center analysis in South Korea

  • Sooyoung Kim;Bit Na Lee;Seung Woo Kim;Ha Young Shin
    • Annals of Clinical Neurophysiology
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    • v.25 no.2
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    • pp.84-92
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    • 2023
  • Background: Clinical spectrum of immunoglobulin M (IgM) monoclonal gammopathy varies from IgM monoclonal gammopathy of unknown significance (IgM-MGUS) to hematological malignancies. We evaluated the clinical features, electrophysiological characteristics, and prognosis of patients with peripheral neuropathy associated with IgM monoclonal gammopathy (PN-IgM MG). Methods: We retrospectively evaluated 25 patients with PN-IgM MG. Peripheral neuropathy was classified as axonal, demyelinating, or undetermined, based on electrophysiological studies. We classified the enrolled patients into the IgM-MGUS and malignancy groups, and compared the clinical and electrophysiological features between the groups. Results: Fifteen patients had IgM-MGUS and 10 had hematologic malignancies (Waldenström's macroglobulinemia: two and B-cell non-Hodgkin's lymphoma: eight). In the electrophysiological evaluation, the nerve conduction study (NCS) criteria for demyelination were met in 86.7% of the IgM-MGUS group and 10.0% of the malignancy group. In particular, the distal latencies of the motor NCS in the IgM-MGUS group were significantly prolonged compared to those in the malignancy group (median, 9.1 ± 5.1 [IgM-MGUS], 4.2 ± 1.3 [malignancy], p = 0.003; ulnar, 5.4 ± 1.9 [IgM-MGUS], 2.9 ± 0.9 [malignancy], p = 0.001; fibular, 9.3 ± 5.1 [IgM-MGUS], 3.8 ± 0.3 [malignancy], p = 0.01; P-posterior tibial, 8.3 ± 5.4 [IgM-MGUS], 4.4 ± 1.0 [malignancy], p = 0.04). Overall treatment responses were significantly worse in the malignancy group than in the IgM-MGUS group (p = 0.004), and the modified Rankin Scale score at the last visit was higher in the malignancy group than in the IgM-MGUS group (2.0 ± 1.1 [IgM-MGUS], 4.2 ± 1.7 [malignancy], p = 0.001), although there was no significant difference at the initial assessment. Conclusions: The risk of hematological malignancy should be carefully assessed in patients with PN-IgM MG without electrophysiological demyelination features.

Microsystems for Whole Blood Purification and Electrophysiological Analysis

  • Han, Arum;Han, Ki-Ho;Mohanty Swomitra K.;Frazier A. Bruno
    • JSTS:Journal of Semiconductor Technology and Science
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    • v.5 no.1
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    • pp.1-10
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    • 2005
  • This paper presents the development of a microsystem for whole blood purification and electrophysiological analysis of the purified cells. Magnetophoresis using continuous diamagnetic capture (DMC) was utilized for whole cell purification and electrical impedance spectroscopy (EIS) was utilized for electrophysiological analysis of the purified cells. The system was developed on silicon and plastic substrates utilizing conventional microfabrication technologies and plastic microfabrication technologies. Using the magnetophoretic microseparator, white blood cells were purified from a sample of whole blood. The experimental results of the DMC microseparator show that 89.7% of the red blood cells (RBCs) and 72.7% of the white blood cells (WBCs) could be continuously separated out from a whole blood using an external magnetic flux of 0.2 T. EIS was used as a downstream whole cell analysis tool to study the electrophysiological characteristics of purified cells. In this work, primary cultured bovine chromaffin cells and human red blood cells were characterized using EIS. Further analysis capabilities of the EIS were demonstrated by successfully obtaining unique impedance signatures for chromaffin cells based on the whole cell ion channel activity.

Electrophysiological Study of Medial Plantar Nerve in Idiopathic Tarsal Tunnel Syndrome (특발성 발목터널 증후군에서 내측 발바닥 신경의 전기 생리학적 검사)

  • An, Jae Young;Kim, Byoung Joon
    • Annals of Clinical Neurophysiology
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    • v.8 no.2
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    • pp.146-151
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    • 2006
  • Background: Tarsal tunnel syndrome (TTS) is an entrapment neuropathy of the tibial nerve within fibrous tunnel on the medial side of the ankle. The most common cause of TTS is idiopathic. This is a retrospective study to define the electrophysiological characteristics of idiopathic TTS. Methods: We reviewed the medical and electrophysiological records of consecutive patients with foot sensory symptoms referred to electromyography laboratory. Inclusion of patients was based on clinical findings suggestive of TTS. Among them, patients with any other possible causes of sensory symptoms on the foot were excluded. Control data were obtained from 19 age-matched people with no sensory symptoms or signs. Routine motor and sensory nerve conduction study (NCS) including medial plantar nerve (MPN) using surface electrodes were performed. Result: Twenty one patients (13 women, 8 men, 9 unilateral, 12 bilateral) were enrolled to have idiopathic TTS (total 31 feet). Tinel's sign was positive in 16 feet (51.6%) of TTS and four feet (10.5%) in control group. The statistically significant electrophysiological parameter was difference of sensory conduction velocity (SCV) between sural nerve and MPN. Amplitude of sensory nerve action potential and SCV of MPN were not different significantly between idiopathic TTS feet and controls. Conclusion: Bilateral development in idiopathic TTS was more common. Tinel's sign and difference of SCV between sural nerve and MPN may be helpful for the diagnosis of idiopathic TTS.

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Electrophysiological Analysis in Diabetic Patients with Abnormal Sensation and Pain (이상감각과 통증을 호소하는 당뇨병 환자의 전기생리학적 특징 분석)

  • Yang, Jiwon;Lee, Yeong-Bae
    • Science of Emotion and Sensibility
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    • v.19 no.4
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    • pp.111-118
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    • 2016
  • Patients with type 2 diabetes mellitus can complain of abnormal sensation and pain which derived from the peripheral nerve damage. Various words used to be describe abnormal sense and pain, such as sharp, hot, dull, cold, sensitive, and itch. To diagnose diabetic peripheral neuropathy, several screening instruments (Neuropathic Pain Scale, NPS; Michigan Neuropathy Screening Instruments, MNSI) and electrophysiological study can be used. In this study, we aim to analyze and compare the clinical and electrophysiological characteristics of 11 patients with diabetes mellitus and abnormal sense/pain (Disease Group, DG) and 10 patients with diabetes mellitus and normal sense (Control Group, CG). In addition, we aim to reveal correlation between NPS subscore and electrophysiological parameters. As a result, the scores of NPS and MNSI in DG were significantly higher. In nerve conduction study, median motor nerve and peroneal nerve showed significant functional change. Also, median motor nerve, posterior tibial nerve and sural nerve showed negative correlation as NPS subscore increased. These results mean increased pain can be associated with abnormal nerve function. It needs to be further explored for larger size of subjects to get confirmative results.

Pharmacological and electrophysiological characterization of rat P2X currents

  • Li, Hai-Ying;Oh, Seog-Bae;Kim, Joong-Soo
    • International Journal of Oral Biology
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    • v.33 no.1
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    • pp.1-5
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    • 2008
  • Adenosine 5'-triphosphate (ATP) is an important extracellular signaling molecule which is involved in a variety of physiological responses in many different tissues and cell types, by acting at P2 receptors, either ionotropic (P2X) or G protein-coupled metabotropic receptors (P2Y). P2X receptors have seven isoforms designated as $P2X_{1^-}P2X_7$. In this study, we investigated the electrophysiological and pharmacological properties of rat $P2X_{1^-}P2X_4$ currents by using whole-cell patch clamp technique in a heterologous expression system. When ATP-induced currents were analyzed in human embryonic kidney (HEK293) cells following transient transfection of rat $P2X_{1^-}P2X_4$, the currents showed different pharmacological and electrophysiological properties. ATP evoked inward currents with fast activation and fast desensitization in $P2X_{^1-}$ or $P2X_{3^-}$ expressing HEK293 cells, but in $P2X_{2^-}$ or $P2X_{4^-}$ expressing HEK293 cells, ATP evoked inward currents with slow activation and slow desensitization. While PPADS and suramin inhibited $P2X_2$ or $P2X_3$ receptor-mediated currents, they had little effects on $P2X_4$ receptor-mediated currents. Ivermectin potentiated and prolonged $P2X_4$ receptor-mediated currents, but did not affect $P2X_2$ or $P2X_3$ receptor-mediated currents. We suggest that distinct pharmacological and electrophysiological properties among P2X receptor subtypes would be a useful tool to determine expression patterns of P2X receptors in the nervous system including trigeminal sensory neurons and microglia.