• Annals of Clinical Neurophysiology
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• 제10권1호
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• pp.43-47
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• 2008

Background: Acute brachial plexitis is an acute idiopathic inflammatory disease affecting brachial plexus, which is characterized by initial severe pain in shoulder followed by profound weakness of affected arm. This is a retrospective study to evaluate the clinical and electrophysiological profile of acute brachial plexitis. Methods: Sixteen patients with acute brachial plexitis were sampled. The electrodiagnostic studies included motor and sensory nerve conduction studies (NCSs) of the median and ulnar, sensory NCSs of medial and lateral antebrachial cutaneous nerves, and needle electromyography (EMG) of selected muscles of upper extremities and cervical paraspinal muscles. The studies were performed on both sides irrespective of the clinical involvement. Results: In most of our patient, upper trunk was predominantly affected (14 patients, 87.50%). Only two patients showed either predominant lower trunk affection or diffuse affection of brachial plexus. All had an acute pain followed by the development of muscle weakness of shoulder girdle after a variable interval ($7{\pm}8.95$ days). Ten patients (62.50%) had severe disability. In NCSs, the most frequent abnormality was abnormal lateral antebrachial cutaneous sensory nerve action potentials (SNAPs). On needle EMG, all the patients showed abnormal EMG findings in affected muscles. Conclusions: In this study, pain was the presenting feature in all patients, and the territory innervated by upper trunk of the brachial plexus was most frequently involved. The most common NCS abnormality was abnormal SNAP in lateral antebrachial cutaneous nerve. Our findings support that the electrodiagnostic test is useful in localizing the trunk involvement in acute brachial plexitis.

• 디지털콘텐츠학회 논문지
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• 제19권4호
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• pp.615-620
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• 2018

당뇨병성 다발성 신경병증 환자들을 진단하는 전류지각 역치 시험과 진동 감각 지각 역치의 임상학적 유용성에 대한 평가는 당뇨병성 다발성 신경병증에 대한 진단방법 중의 하나이다. 현재까지 당뇨병성 다발성 신경병증 환자들에 대해 몇 가지 방법들이 사용되어 왔는데, 예를 들면, 하지 신경병증 장애 시험, 신경전도 시험, 냉각감지 역치 시험, 열-고통 역치 시험 등을 들 수 있다. 그러나, 이들 대부분의 시험은 고가이거나 시험하는데 많은 시간을 필요로 한다. 본 논문에서는 진동 감지 능력을 평가하는 새로운 기구가 소개되고, 이를 위해 환자의 말초 신경을 자극하는 보이스 코일 모터(voice coil motor)와 전류 증폭기를 제작하였다. 또한, 당뇨병성 다발성 신경병증 환자들의 정량적 진동 감지 수준을 측정하기 위하여 진동 감지 역치 시험을 센싱하고 구동하는 소프트웨어가 개발되었다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제35권1호
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• pp.25-30
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• 2013

Purpose: Many surgical procedures in oral and maxillofacial area can induce trauma to the peripheral nerve. The aim of the study is to evaluate the effects of short-term steroid therapy on nerve recovery after crush injury. Methods: Sixteen rats were randomly divided into two groups. The right sciatic nerves were exposed, crushed, and sutured. The control group was not given steroids. The test group was injected with dexamethasone disodium phosphate (2 mg/kg body weight/day) for 7 days. In all animals, compound muscle action potential (CMAP) was recorded before and at 1, 7, 14, 21, and 28 days after injury. Results: The amplitude of the CMAP before and at 1, 7, 14, 21, and 28 days after injury were $53.20{\pm}4.80$ mV, $20.12{\pm}5.38$ mV, $30.01{\pm}14.15$ mV, $31.14{\pm}13.56$ mV, $31.73{\pm}16.33$ mV, and $37.23{\pm}16.98$ mV in the control group, and $55.25{\pm}6.72$ mV, $18.62{\pm}6.26$ mV, $29.50{\pm}13.06$ mV, $32.90{\pm}13.226$ mV, $30.17{\pm}11.80$ mV, and $38.41{\pm}12.27$ mV in the test group, respectively. The nerve conduction velocity was $18.82{\pm}3.94$ m/s, $16.73{\pm}3.48$ m/s, $19.60{\pm}2.45$ m/s, $18.68{\pm}3.94$ m/s, $18.02{\pm}3.51$ m/s, and $19.25{\pm}3.88$ m/s in the control group, and $18.94{\pm}3.48$ m/s, $17.28{\pm}2.53$ m/s, $7.57{\pm}2.54$ m/s, $18.77{\pm}2.12$ m/s, $19.48{\pm}1.55$ m/s, and $19.22{\pm}2.97$ m/s in the test group, respectively. There was no significant difference between both groups (P>0.05). Conclusion: This study did not show any therapeutic effect of short-term administration of steroids on injured rat sciatic nerve. Further studies are needed.

• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.31-34
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• 2004

Backgrounds: The pathway of the sural nerve (SN) is variable, but usually divided into medial and lateral sural branches joining the posterior tibial nerve (PTN) and the peroneal nerve (PN). The sural nerve may be affected by PN palsy. The frequency or the severity of SN involvement in peroneal palsy is not known. The purpose of the study is to investigate the frequency and the severity of the SN involvement by the peroneal nerve palsy. Methods: Total 85 patients were included with peroneal palsy. Amplitudes of distal peroneal, sural, and superficial peroneal nerves (SPN) were compared between normal and paralyzed sides. The frequency and severity of SN involvement by peroneal palsy were investigated. Results: Mean age was $48.4{\pm}17.4$ years old at the time of the test. Peroneal palsy was right side in 32, left in 38, and bilateral in 15 patients. Mean amplitudes of affected distal PN, SPN, and SN were $1.51{\pm}1.64mV$, $3.50{\pm}4.86{\mu}V$, and $10.42{\pm}6.59{\mu}V$ in right side, and $1.19{\pm}1.57mV$, $4.38{\pm}5.67{\mu}V$, and $11.06{\pm}6.87{\mu}V$ in left side, respectively. Sensory nerve action potential (SNAP) amplitude of the SN in the affected side was average $73.7{\pm}33.1%$ of normal, which was significantly lower than that in the normal side(p<0.01). The decrease of the sural SNAP amplitude was more than 15% in 39 out of 70 patients with unilateral peroneal palsy. Peroneal compound muscle action potential (CMAP) amplitude was not correlated with the amplitude of the sural SNAP. By complete peroneal palsy, SN SNAP amplitude was decreased to 4% of SNAP and $57.7{\pm}31.8%$ of that in normal side. Conclusions: PN injury without PTN involvement may induce reduction of sural SNAP amplitude. Because of the anatomic variation of SN, the electrophysiological findings are variable. It should be considered to interpret the location of the PN lesion.

• Annals of Clinical Neurophysiology
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• 제5권2호
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• pp.181-186
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• 2003

Background: Somatosensory evoked potential (SSEP) is valuable for the evaluation of the central pathway. However, peripheral neuropathy sometimes renders the test useless by preventing the conduction from reaching the CNS. We postulated that the peripheral conduction problems could be overcome by proximal stimulation in SSEP and wanted to verify this in the study. Methods: Twenty patients with diabetic sensorimotor polyneuropathy were included. SSEP was elicited by stimulating the median and posterior tibial nerves. We compared the effect of distal and proximal stimulations in each SSEP in the aspect of presence/absence and various latencies of resultant waves. Results: Among the 40 cases, proximal stimulation caused reappearance of subsided waves in 10 cases (25%). In the median nerve SSEP, proximal stimulation made EN1 and CN2 visible which were not evident when distally stimulated. In the posterior tibial nerve SSEP, there was also improvement of forming waves when proximally stimulated. Conclusions: In the diabetic polyneuropathy, proximal stimulation of SSEP is more effective than the conventional distal stimulation in evaluating central pathway.

• Journal of Preventive Medicine and Public Health
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• 제29권3호
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• pp.507-519
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• 1996

The objectives of this study are to investigate the prevalence of occupation related carpal tunnel syndrome(CTS) among workers in a condom industry : to analyse the sensitivity and specificity of clinical signs or symptoms such as hand diagram, Tinel's sign and Phalen's sign in carpal tunnel syndrome : and to test vibration threshold test using audiometry as a technically easy and noninvasive method in the diagnosis of carpal tunnel syndrome in stead of nerve conduction velocity (NCV). The study group was divided into exposed group(39 cases) and non-exposed group(48 cases) based on whether or not excessive use of wrist movements exsist. 1. There are stastically significant differences in symptoms and signs of carpal tunnel syndrome such as hand diagram, Tinel's sign and Phalen's sign between exposed and non-exposed group(p<0.05). 2. Six cases(9 hands) were comfirmed as carpal tunnel syndrome by NCV. Five cases(7 hands) belonged to exposed group, 1 case(2 hands) to nonexposed group. As there are significant differences in prevalence of carpal tunnel syndrome between two groups(p<0.05), excessive use of wrist in occupation is a risk factor of carpal tunnel syndrome. 3. When we use NCV as a gold standard in the diagnosis of carpal tunnel syndrome, sensitivity and specificity of hand diagram, Tinel's sign and Phalen's sign is as followed; hand diagram , sensitivity 88.9%, specificity 84.2% Tinel's sign ; sensitivity 55.6%, specificity 72.8% Phalen's sign ; sensitivity 14.3%, specificity 88.4%. Among above clinical signs and symptoms, hand diagram is the best clinical screening test. 4. The differences of vibration threshold between median and ulnar nerve at the same time are useful in the diagnosis of carpal tunnel syndrome but the time change of vibration threshold of median nerve over time are not sensitive enough. It is concluded that vibration threshold between median and ulnar nerve at the same time can be used as a supplementary or alternative criterion to indicate that the nerve dysfunction is located in the carpal tunnel.

• PNF and Movement
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• 제19권1호
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• pp.97-104
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• 2021

Purpose: The human body can experience a variety of injuries. As a result, it may be difficult to directly treat the damaged area. In such a case, indirect treatment is required. Indirect treatment is typically PNF treatment. Morphological changes in muscle have been confirmed through several previous studies; however, few studies have analyzed neurological changes. Therefore, the purpose of this study was to determine how irradiation during resistance exercise using a diagonal pattern effects neurological excitability. Methods: Electromyography was performed on 13 healthy adults. A compound muscle action potential (CMAP) was obtained through a median motor nerve conduction velocity test, which was conducted before and after performing the irradiation exercise and general exercise. Results: Compared to baseline measurements, there was no significant difference in the latency of the irradiation exercise and general exercise. The amplitude of the CMAP measured after the irradiation exercise was significantly higher than after general exercise. Conclusion: Neurological excitability was high in irradiation during resistance exercise using a diagonal pattern. When clinically direct treatment is difficult, it is thought that irradiation can be used indirectly as a technique to induce nerve excitability.

• Annals of Clinical Neurophysiology
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• 제7권2호
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• pp.117-120
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• 2005

Hemifacial spasm (HFS) may develop after Bell's palsy (BP). But it was not reported that contralateral HFS occurred simultaneously in acute BP. A 25-year-old woman admitted with left HFS occurred simultaneously in acute right BP for 6 days. Past, family, and social history were unremarkable. Nerve conduction studies (NCS) and blink reflex (BR) test showed bilateral facial neuropathies. Brain MRI and cerebral angiography were normal. The symptoms and signs of HFS and BP were improved slowly after acyclovir and prednisolone therapy. Follow-up serial NCS and BR also showed a rapid improvement.

• Annals of Clinical Neurophysiology
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• 제9권2호
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• pp.97-101
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• 2007

We report a 31-year-old man with cerebral adrenomyeloneuronopathy variant, who presented as progressive gait disturbance. He had spastic paraparesis, hyperreflexia without Babinski's sign and sensory symptom. No adrenal insufficiency was noted. Brain MRI showed extensive high signal intensities in bilateral temporal lobes and posterior periventricular white matter in T2 weighed imaging without cerebrospinal fluid abnormality. His nerve conduction study showed sensorimotor demyelinating polyneuropathy and the level of saturated very-long-chain fatty acids was high in his plasma, although neuropsychological test was normal.

• Journal of Yeungnam Medical Science
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• 제32권2호
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• pp.127-131
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• 2015

Churg-Strauss syndrome (CSS) is a necrotizing vasculitis with extra-, peri-vascular eosinophilic infiltration. Chronic symmetric polyarthritis with the presence of rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody are the mainstay of rheumatoid arthritis (RA) diagnosis. Mononeuritis multiplex is a peripheral neuropathy involving more than 2 separate nerve areas. A 62-year-old male patient was referred for left foot drop and polyarthritis of both hands and feet for 4 months. During evaluation, mononeuritis multiplex was detected on nerve conduction study and electromyography tests: vasculitis with neutrophil, eosinophil, and lymphocyte infiltration on peroneal nerve biopsy. A positive response to methacholin and bronchodilator was observed on the pulmonary function test. Radiologic tests showed peri-articular soft tissue swelling and osteopenia on both hand and foot. Marked peripheral eosinophilia, high RF, and positive perinuclear anti-neutrophil cytoplasmic antibody were detected on blood tests. Here, we report on a patient with overlap syndrome of CSS and RA with review of the relevant literature, from which a few references to overlap syndrome of CSS and RA were available.