• Title/Summary/Keyword: Muscles, denervation

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A Study for the Distinction between Denervation Potentials and Endplate Spikes for the Diagnosis of Neuropathy (신경질환의 진단을 위한 탈신경 전위와 종판 전위의 구별에 관한 연구)

  • 임재중;김남균;황윤성;박인선
    • Journal of Biomedical Engineering Research
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    • v.20 no.4
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    • pp.451-459
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    • 1999
  • During the electromyographic evaluation for the diagnosis of neuropathy, presence for site of lesion could be predicted by a detection of denervation potentials such as fibrillation potentials or positive sharp waves in a group of muscles. Unfortunately, since denervation potentials are distinguished by examiner's experience, it is possible to make mistake identifying endplate spikes as a denervation potential. The aim of the study was to extract parameters to make an algorithm for quantitative distinction between denervation potentials and endplate spikes. It will help to minimize the examiner's bias and to localize the site of lesion thus increase the reliability on EMG diagnosis. There types of signals, endplate spike, fibrillation potential and positive sharp wave were obtained from the EDB(extensor digitorum brevis) muscle using then neuropathic patients. Eight parameters such as duration, area, slope, peak-to-peak amplitude, positive peak negative peak amplitude, ratio of positive to negative peak amplitude, and number of phase were extracted and compared. As a results, peak-to-peak amplitude, positive peak amplitude, ratio of positive to negative peak amplitude showed statistically significant differences between endplate spikes and denervation potentials. It was concluded that those parameters could be used to establish an algorithm which will improve the accuracies in automated quantitative EMG diagnosis.

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A Case of Herpes Zoster Myelitis -A case report- (대상포진 척수염을 동반한 대상포진 치험 1예 -증례 보고-)

  • Yang, In-Sook;Lim, Geun-Duk;Shin, Sung-Shick
    • The Korean Journal of Pain
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    • v.10 no.2
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    • pp.266-269
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    • 1997
  • Herpes zoster is a relatively common disease caused by Varicella-Zoster virus and characterized by a vesicular dermatomal rash and a variety of neurologic manifestations. These neurologic symptoms include herpes zoster neuralgia, myelitis, encephalitis, cranial arteritis, segmental and rarely polyradiculitis. This report is a case of a 57-year-old female with herpes zoster paresis affecting the arm and hand. Herpetic pain was much relieved after continuous cervical epidural blockade. However, fifty days after onset of ailment, she complained motor paralysis. EMG of muscles innervated by the left $C_8$ and $T_1$ roots revealed high frequency denervation potentials and large amplitude polyphasic motor units. We recommended physiotherapy and aggressive exercise therapy of the hand. After eighty days of therapy, denervated spontaneous activities disappeared on EMG. Clinically, strength of muscles had nearly recovered to 75% of normal strength in left hand intrinsics.

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Correction of post-traumatic anterior open bite by injection of botulinum toxin type A into the anterior belly of the digastric muscle: case report

  • Seok, Hyun;Park, Yong-Tae;Kim, Seong-Gon;Park, Young-Wook
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.4
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    • pp.188-192
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    • 2013
  • Post-traumatic anterior open bite can occur as a result of broken balance among the masticatory muscles. The superior hyoid muscle group retracts the mandible downward and contributes to the anterior open bite. Denervation of the digastric muscle by injection of botulinum toxin type A (BTX-A) can reduce the power of the digastric muscle and help to resolve the post-traumatic anterior open bite. A patient with a bilateral angle fracture had an anterior open bite even after undergoing three operations under general anesthesia and rubber traction. Although the open bite showed some improvement by the repeated operation, the occlusion was still unstable six weeks after the initial treatment. To eliminate the residual anterior open bite, BTX-A was injected into the anterior belly of the digastric muscle. Following injection of BTX-A, the anterior open bite showed immediate improvement. Complication and relapse were not observed during follow-up. Long-standing post-traumatic open bite could be successfully corrected by injection of BTX-A into the anterior belly of the digastric muscle without complication.

Effect of endurance exercise during acute stage on hindlimb muscles of stroke induced rat (지구력 운동이 급성기 뇌졸중 쥐의 뒷다리근 질량에 미치는 영향)

  • An, Gyeong-Ju;Lee, Yoon-Kyong;Im, Ji-Hae;Choi, S-Mi;Choe, Myoung-Ae
    • Journal of Korean Biological Nursing Science
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    • v.2 no.2
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    • pp.67-80
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    • 2000
  • The purpose of this study was to identify hindlimb muscle atrophy in stroke induced rat and determine the effect of endurance exercise on body weight, weight of hindlimb muscle during 7 days after stroke induction. Thirty four male Sprague-Dawley rats with 200-270g body weight were divided into four groups : control, control+exercise(Con+Ex), stroke, and exercise after stroke(St+Ex) group. The control group and Con+Ex group received sham operation and the stroke group and St+Ex group received right MCA occlusion operation by using silicon-coated probe. The Con+Ex and St+Ex groups ran on a treadmill for 20min/day at 10m/min and $10^{\circ}grade$. Daily body weight and diet intake were measured every morning for 7 days. Cerebral infarction of stroke and St+Ex groups were identified by staining with TCC for 30minutes. The data were analyzed by Kruskal-Wallis test and Mann-Whitney U test using the SPSSWIN 9.0 program. Body weight of the control group at the 7th day increased by 18.3% significantly from the first day of experiment, that of the stroke group at the 7th day decreased by 6.7% significantly compared to the day of receiving right MCA occlusion operation. Body weight of the Con+Ex group at the 7th day increased by 10.3% significantly form the first day of experiment, that of St+Ex group at the 7th day also increased by 13.4% significantly compared to the day of receiving right MCA occlusion operation. The total amount of diet in stroke group decreased significantly compared to that of St+Ex and that of control group. In stroke group the wet weight of both sides of soleus, plantaris, and gastrocnemius muscles decreased significantly compared to that of control group. The relative weight of affected(left) plantaris and gastrocnemius muscles decreased significantly compared to that of the control group. The difference between the weight of affected and unaffected soleus, plantaris, and gastrocnemius muscles were not significant in stroke group. The wet weight of right gastrocnemius muscles in Con+Ex group increased compared to that of control group. The relative weight of right gastrocnemius muscle increased significantly compared to that of the control group. The wet weight of St+Ex group increased significantly compared to that of the stroke group in both sides of soleus, plantaris, and gastrocnemius muscles. The relative weight of affected plantaris muscle increased significantly compared to that of the stroke group. The difference between the weight of affected and unaffected soleus, plantaris, and gastrocnemius muscles were not significant in St+Ex group. Body weight and wet weight of soleus, plantaris, and gastrocnemius muscles in the St+Ex group did not recover to the values of control group. Based on these results, it can be suggested that endurance exercise during acute stage of stroke can reduce muscle atrophy related to denervation, inactivity and undernutrition.

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Herniation after deep circumflex iliac artery flap: two cases of rare complication

  • Kim, Hee-Sung;Kim, Jae-Young;Hur, Hyuk;Nam, Woong
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.38
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    • pp.10.1-10.5
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    • 2016
  • Herniation after harvesting of deep circumflex iliac artery (DCIA) flap is a known but not a common complication. It occurs about 2.8 to 9 % according to the literatures and can proceed to a more severe complication such as bowel obstruction. There are several factors that exacerbate the risk: surgical factors, operator factor, and patient factors. Surgical factors include large anatomical defect and denervation of related muscles. Operator factor stands for unpunctual suture technique. Patient factors represent obesity, diabetes, pulmonary disease, smoking habits, and so on. Thus, herniation might occur regardless of meticulous suture. Herein, we would like to report two cases of herniation after DCIA flap harvesting and repaired by Lichtenstein tension-free hernioplasty with literature review.

Myofascial Orofacial Pain Exacerbated after Masseteric Nerve Neurectomy

  • Nam, Hyun;Ko, Daeun;Kang, Jin-Kyu;Shim, YoungJoo
    • Journal of Oral Medicine and Pain
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    • v.45 no.4
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    • pp.110-114
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    • 2020
  • Myofascial pain (MFP) is one of the most common causes of persistent orofacial pain. Patients with chronic myofascial orofacial pain may present with diffuse heterotopic pain, complicating the correct diagnosis. Treatment of chronic MFP should focus on the elimination of aetiologic factors. This article describes two cases of chronic MFP of the masticatory muscles, whose symptoms were exacerbated after masseteric nerve neurectomy. The patients had suffered from irrelevant treatment which did not resolve the symptom. Their symptom was managed by conventional treatment protocol. These cases emphasize the importance of correct diagnosis and evidence-based approach.

A Man Presenting with Sudden Weakness and Pain of the Right Hand, by Non-Small Cell Lung Cancer with Brain Metastases (비소세포폐암의 뇌전이로 인한 갑작스런 수부 통증 및 마비)

  • Sung, Won Jin;Hong, Bo Young;Kim, Joon Sung;Yoo, Jae Wan;Lim, Seong Hoon
    • Clinical Pain
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    • v.18 no.2
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    • pp.88-91
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    • 2019
  • Unexplained pain and weakness, i.e., without obvious predisposing factors, are often encountered by physiatrists and efforts should be made to determine the cause. A 63-year-old male presented with radiating pain in his right arm and mild weakness of the right hand. An electrodiagnostic examination revealed distal symmetric sensory polyneuropathy in the upper and lower extremities, and denervation potentials in the forearm muscles, which were inconsistent with the cervical spine MRI images and symptoms. A predisposing undiscovered disease was revealed, i.e., squamous cell carcinoma in the lung; brain metastasis affecting the left primary motor cortex was also detected. Therefore, we concluded that the pain and weakness were related to paraneoplastic syndrome and brain metastases of the hand knob. The observed denervation potentials were characterized as trans-synaptic changes in the brain metastasis. This case highlights the importance of unexplainable focal pain and weakness in the increasing prevalence of cancer.

A case of neonatal peroneal neuropathy with intrauterine onset (신생아 종아리신경병증 1례)

  • Lee, Sang-Soo;Sim, Ji-Yun;Kim, Mi-Jung
    • Clinical and Experimental Pediatrics
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    • v.50 no.6
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    • pp.585-587
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    • 2007
  • Peroneal neuropathy presenting at birth is a rare disorder. Although neonatal mononeuropathies may be related to obstetrical complications, prenatal mechanisms should be also considered. We describe an infant who was born at term by cesarean section due to breech presentation with a unilateral footdrop. Lack of compound muscle action potential in the peroneal nerve and denervation potentials confined to the tibialis anterior and the extensor hallucis longus muscles in the electrophysiological studies on the fourth day of life strongly suggest an isolated peroneal neuropathy of intrauterine onset. Early and sequential electrodiagnostic studies will be important to provide better temporal and pathophysiologic definitions, the better timing of onset and prognosis for mononeuropathies presenting in newborn infants.

A Case of Thyroarytenoid Myoneurectomy Using LASER and Monopolar Electrical Device in Spasmodic Dysphonia (연축성 발성장애 환자에서 레이저와 단극성 전기소작기를 이용한 갑상피열근신경 절제술 1예)

  • Lee, So Jeong;Jung, Soo Yeon;Chung, Sung Min;Kim, Han Su
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.30 no.2
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    • pp.132-135
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    • 2019
  • Spasmodic dysphonia is a focal laryngeal dystonia that results in involuntary spasms during speech. The etiology of spasmodic dysphonia is not yet defined, but it is presumed to be a neurological abnormality of central nervous system motor function. The treatment of choice for spasmodic dysphonia is botulinum toxin injection directly at the laryngeal muscles. However botulinum toxin injection requires repeated procedures. Many different kinds of surgical treatments have been introduced but the recurrence rate is still high. So we performed myomectomy with LASER and neurectomy with specially designed electrical surgical knife which can cut recurrent laryngeal nerve branch selectively with its noble curved section. We report a case of a 43-year-old male patient with spasmodic dysphonia treated by thyroarytenoid myoneurectomy.

Bibrachial Amyotrophy Associated with Epidural Cerebrospinal Fluid Leakage: A Case Report (경막외 뇌척수액 누출과 연관된 양측 상지 근위축증: 증례보고)

  • Rho, Hyunwoo;Jeong, Jiseon;Sung, Duk Hyun
    • Journal of Electrodiagnosis and Neuromuscular Diseases
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    • v.20 no.2
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    • pp.112-118
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    • 2018
  • We describe a case of a 71-year-old male patient who experienced progressive bilateral proximal upper limb weakness and atrophy without sensory symptoms and signs over 5 years. Electromyography demonstrated denervation potentials and neuropathic motor unit action potentials on C5-C7 myotome muscles bilaterally. Cervical spine magnetic resonance imaging revealed engorged anterior epidural venous plexus, T2 hyperintensity localized to grey matter ("snake-eye" appearance) at C2-C6 vertebral level, and ventral epidural fluid collection from C6 to T8 vertebral level. This case indicates that bibrachial amyotrophy associated with epidural fluid leak should be suspected in patients presenting with progressive bilateral upper limb weakness and atrophy without sensory involvement.