• Annals of Clinical Neurophysiology
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• 제6권1호
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• pp.20-25
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• 2004

Background and Objectives: The proximal and distal nerve segments are preferentially involved in acquired demyelinating polyneuropathies (ADP). This study was undertaken in order to assess the usefulness of motor evoked potential (MEP) and somatosensory evoked potential (SSEP) in the detection of the proximal nerve lesion in ADP. Methods: MEP, SSEP and conventional NCS were performed in 6 consecutive patients with ADP (3 AIDP, 3 CIDP). MEP was recorded from abductor pollicis brevis and abductor hallucis using magnetic stimulation of the cortex and the cervical/lumbar spinal roots. SSEP were elicited by stimulating the median and posterior tibial nerves. Latency from cortex and cervical/lumbar roots, central motor conduction time (CMCT), EN1-CN2 interpeak latency were measured for comparison. Results: MEP was recorded in 24 limbs (12 upper and 12 lower limbs) and SSEP in 24 limbs (12 median nerve, 12 posterior tibial nerve). F-wave latency was prolonged in 25 motor nerves (25/34, 73.5%). Prolonged CML and PML were found in 41.7% (10/24) and 45.8% (11/24), respectively. Interside difference (ISD) of CMCT was abnormally increased in the upper extremity, 66.7% (4/6 pairs) in case of CML-PML. EN1-CN2 interpeak latency was abnormally prolonged in one median nerve (1/10) and LN1-P1 interpeak latency was normal in all posterior tibial nerves. Conclusions: MEP and SSEP may provide useful information for the proximal nerve and root lesion in ADP. MEP and SSEP is supplemental examination as well as complementary to conventional NCS.

• Journal of Korean Neurosurgical Society
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• 제53권5호
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• pp.269-273
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• 2013

Objective : Posture induced common peroneal nerve (CPN) palsy is usually produced during the prolonged squatting or habitual leg crossing while seated, especially in Asian culture and is manifested by the onset of foot drop. Because of its similarity to discogenic foot drop, patients may be diagnosed with a lumbar disc disorder, and in some patients, surgeons may perform unnecessary examinations and even spine surgery. The purpose of our study is to establish the clinical characteristics and diagnostic assessment of posture induced CPN palsy. Methods : From June 2008 to June 2012, a retrospective study was performed on 26 patients diagnosed with peroneal nerve palsy in neurophysiologic study among patients experiencing foot drop after maintaining a certain posture for a long time. Results : The inducing postures were squatting (14 patients), sitting cross-legged (6 patients), lying down (4 patients), walking and driving. The mean prolonged neural injury time was 124.2 minutes. The most common clinical presentation was foot drop and the most affected sensory area was dorsum of the foot with tingling sensation (14 patients), numbness (8 patients), and burning sensation (4 patients). The clinical improvement began after a mean 6 weeks, which is not related to neural injury times. Electrophysiology evaluation was performed after 2 weeks later and showed delayed CPN nerve conduction study (NCS) in 24 patients and deep peroneal nerve in 2 patients. Conclusion : We suggest that an awareness of these clinical characteristics and diagnostic assessment methods may help clinicians make a diagnosis of posture induced CPN palsy and preclude unnecessary studies or inappropriate treatment in foot drop patients.

• Restorative Dentistry and Endodontics
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• 제20권2호
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• pp.527-537
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• 1995

The effect of calcitonin gene-related peptide (CGRP), substance P (SP) and electrical stimulation of the tooth on the intradental nerve activtiy (INA) was investigated in anesthetized cats. The INA was recorded from single pulp nerve units dissected from the inferior alveolar nerve under stereomicroscope. The INA elicited by 3 minute application of 4M NaCl in deep dentinal cavity was compared before and after stimulation at 10 minute intervals. The magnitude of INA was calculated as the total number of nerve impulses produced in given period, and the changes of INA are expressed as % of control INA. The results obtained were as follows. 1. 16 single pulp nerve units were classified as 14 $A{\delta}$-fibers (3.4~19.4m/sec) and 2-fibers (1.5~1.7m/sec) according to the conduction velocity. 2. 4M NaCl evoked an irregular bursts of spikes which continued until washing out. Isotonic saline did not affect INA to subsequent applications of the hypertonic NaCl solution (P>0.05). 3. Local application of CGRP ($200{\mu}g$/ml) in deep dentinal cavity reduced the INA induced by 4M NaCl in $A{\delta}$-fiber units (P<0.01) and some units of those responded to CGRP during application. 4. Local application of SP ($100{\mu}g$/ml) in deep dentinal cavity reduced the INA induced by 4M NaCl in AS-fiber units (p<0.05), but increased the INA in C-fiber unit coincided with large reduction of the INA of $A{\delta}$-fiber units. 5. Monopolar electrical stimulation applied to the crown at intensities high enough to excite C-fibers (12V, 5ms, 10Hz, 10~30min) decreased the INA in $A{\delta}$-fiber units (P<0.01) and systemic pretreatment with phenoxybenzamine (3mg/kg, i.v.) enhanced this inhibitory effect (P<0.01). On the contrary, electrical stimulation increased the INA in C-fiber unit.

• Journal of Korean Neurosurgical Society
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• 제55권3호
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• pp.148-151
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• 2014

Objective : Posture-induced radial neuropathy, known as Saturday night palsy, occurs because of compression of the radial nerve. The clinical symptoms of radial neuropathy are similar to stroke or a herniated cervical disk, which makes it difficult to diagnose and sometimes leads to inappropriate evaluations. The purpose of our study was to establish the clinical characteristics and diagnostic assessment of compressive radial neuropathy. Methods : Retrospectively, we reviewed neurophysiologic studies on 25 patients diagnosed with radial nerve palsy, who experienced wrist drop after maintaining a certain posture for an extended period. The neurologic presentations, clinical prognosis, and electrophysiology of the patients were obtained from medical records. Results : Subjects were 19 males and 6 females. The median age at diagnosis was 46 years. The right arm was affected in 13 patients and the left arm in 12 patients. The condition was induced by sleeping with the arms hanging over the armrest of a chair because of drunkenness, sleeping while bending the arm under the pillow, during drinking, and unknown. The most common clinical presentation was a wrist drop and paresthesia on the dorsum of the 1st to 3rd fingers. Improvement began after a mean of 2.4 weeks. Electrophysiologic evaluation was performed after 2 weeks that revealed delayed nerve conduction velocity in all patients. Conclusion : Wrist drop is an entrapment syndrome that has a good prognosis within several weeks. Awareness of its clinical characteristics and diagnostic assessment methods may help clinicians make diagnosis of radial neuropathy and exclude irrelevant evaluations.

• 대한예방의학회:학술대회논문집
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• 대한예방의학회 1994년도 교수 연수회(환경)
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• pp.545-548
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• 1994

Eletrophysiological methods revealed subclinical neuropathy in 26 workers, exposed from 1 to 17 years to lead and whose blood lead (PbB) values had never exceeded $70{\mu}g/100\;ml$, as ascertained by checking the monitor reports of the factory and by careful exposure history. The PbB determinations had been tested repostedly and had been found valid. The main findings were slowing of the maximal motor conduction velocities of the median and ulnar nerves and particularly the conduction velocity of the slower fibers of the ulnar nerve. Eletrophysiological abnormalities comprised fibriliations, diminution of the number of motor units on maximal contraction, and an abnormal. Thus, a dose-response relationship exlets on a group basis. Since the regular monitoring of PbBs in most workers during their entire period of exposure excludes the possibility of a body burden out of proportion to the PbBs silght neuro-logical damage is produced at exposures hitherto regarded as quite sale.

• Annals of Clinical Neurophysiology
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• 제3권1호
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• pp.40-42
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• 2001

Anorexia nervosa(AN) is a disorder characterized by disturbance of body image, fear of gaining weight, severe weight loss and, in female, amenorrhea. Compared with normal persons, patients with AN have neuropathic symptoms more frequently. But electrophysiologic abnormalities have rarely been reported. We experienced a case with recurrent neuropathic symptoms after severe weight loss. Further evaluation revealed AN. Electrophysiologic study showed sensorimotor polyneuropathy and focal neuropathy with conduction block. As far as we know, this feature of neuropathy in AN has not been described. We describe unusual feature of neuropathy in our patient with literature review.

• Journal of Genetic Medicine
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• 제15권2호
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• pp.107-109
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• 2018

X-linked Charcot-Marie-Tooth disease type 1 (CMTX1) is caused by the mutation in GJB1 gene, characterized by the transient central nervous system involvement and long standing peripheral polyneuropathy which does not fulfill the criteria of demyelination or axonopathy. We describe a 37-year-old man with progressive bilateral leg weakness since his early teen. He suffered transient right hemiparesis, followed by quadriparesis at 14 years of age. When we examined him at 37 years of age, he presented a distal muscle weakness on lower extremities with a sensory symptom. The nerve conduction study demonstrated a motor conduction velocity between 26 and 49 m/s. The whole exome sequencing revealed a novel variant c.136 G>A in GJB1. This report will raise awareness in this rare disease, which is frequently misdiagnosed early in its course.

• 대한물리치료과학회지
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• 제3권1호
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• pp.929-941
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• 1996

본 연구는 1994년 1월 24일부터 동년 4월 8일까지 부산 메리놀병원 내과 및 신경과에서 당뇨병으로 진단되어 당뇨교실에서 치료를 받고 있는 입원 및 외래환자 67명(남 37명, 여 30명 :평균연령 $52.55{\pm}13.67$세)과 병력 및 이학적 소견상 말초신경에 이상이 없다고 진단된 직원 및 그 가족 53명(남 28명, 여 25명 : 평균연령 $45.75{\pm}12.21$세)을 대상으로 본 병원 신경생리검사실에서 가중침자감각역치와 감각신경전도검사를 측정한 결과는 다음과 같다. 1. 가중침자감각역치는 양측 손과 발의 측정한 모든 부위에서 당뇨병 환자 중 증상군, 무증상군 그리고 대조군 간에 있어서 통계학적으로 유의한 차이를 나타냈는데, 대조군이 당뇨병 환자군보다 낮았고 당뇨병 환자중 무증상군이 증상군보다 낮게 나타났다. 2. 당뇨병 환자에 있어서 가중침자감각역치는 증상군과 무증상군 모두 연령과 당뇨병유병기간과는 통계학적으로 유의한 상관관계를 나타내어 연령이 많고 유병기간이 길수록 가중침자감각역치는 높았으며 기타 체중, 신장 및 교육수준과는 유의한 상관성이 없었다. 3. 대조군에 있어서 가중침자감각역치는 연령과는 통계학적으로 유의한 상관관계를 나타냈고 교육수준과는 역상관관계를 나타내어 연령이 많고 교육수준이 낮을 수록 가중침자감각역치는 높았으며 체중과 신장과는 유의한 상관성이 없었다. 4. 가중침자감각역치에 있어서 연령을 보정하고 각 부위별로 세 군 간의 상관관계를 살펴본 결과 우측 제 5수지와 좌측 발에서의 가중침자감각역치는 증상군과 무증상군, 증상군과 대조군 및 무증상군과 대조군 간에 모두 통계학적으로 유의한 차이를 나타냈으나(p<0.05), 그 외 양측 제 2수지와 좌측 제 5수지 그리고 우측 발에서의 가중침자감각역치는 증상군과 대조군, 그리고 무증상군과 대조군 간에서만 통계학적으로 유의한 차이를 나타냈고 증상군과 무증상군 간에는 유의한 차이가 나타나지 않았다(p<0.05). 5. 각 부위별 가중침자감각역치와 감각신경의 전도속도 및 활동전위 진폭과의 상관관계는 세 군 모두다 측정한 모든 부위에서 통계학적으로 유의한 상관관계를 나타냈다. 이상의 결과로 보아 감각신경 전도검사가 가중침자감각역치보다 정확한 검사이긴 하지만 가중침자감각역치는 당뇨크리닉의 외래에서 말초감각장애 정도를 신속히 알고 싶을 때나, 감각신경 전도검사가 불가능한 상황에서 표피감각을 측정하는데 매우 유용한 검사방법이라 생각된다.

• Journal of Preventive Medicine and Public Health
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• 제28권4호
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• pp.899-910
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• 1995

1994년 1월 24일부터 동년 4월 8일까지 부산 메리놀병원 내과 및 신경과에서 당뇨병으로 진단되어 당뇨교실에서 치료를 받고 있는 입원 및 외래환자 67명(남37명, 여 30명 : 평균연령 $52.55{\pm}13.67$세)라 병력 및 이학적 소견상 말초신경에 이상이 없다고 진단된 직원 및 그 가족 53명(남 28명, 여 25명 : 평균연령 $45.75{\pm}12.21$세)을 대상으로 본 병원 신경생리검사실에서 가중침자감각역치와 감각신경전도검사를 측정한 결과는 다음과 같다. 1. 가중침자감각역치는 양측 손과 발의 측정한 모든 부위에서 당뇨병 환자 중 증상군, 무증상군 그리고 대조군간에 있어서 통계학적으로 유의한 차이를 나타냈는데, 대조군이 당뇨병 환자군보다 낮았고 당뇨병 환자 중 무증상군이 증상군보다 낮게 나타났다. 2. 당뇨병 환자에 있어서 가중침자감각역치는 증상군과 무증상군 모두 연령과 당뇨병유병기간과는 통계학적으로 유의한 상관관계를 나타내어 연령이 많고 유병기간이 길수록 가중침자감각역치는 높았으며 기타 체중, 신장 및 교육수준과는 유의한 상관성이 없었다. 3. 대조군에 있어서 가중침자감각역치는 연령과는 통계학적으로 유의한 상관관계를 나타냈고 교육수준과는 역상관관계를 나타내어 연령이 많고 교육수준이 낮을수록 가중침자감각역치는 높았으며 체중과 신장과는 유의한 상관성이 없었다. 4. 가중침자감각역치에 있어서 연령을 보정한 후의 각 부위별 세 군간의 차이는 우측 제5수지와 좌측 발에서는 세 군 서로 모두 통계학적으로 유의한 차이를 나타냈으나(p<0.05), 양측 제2수지와 좌측 제5수지 그리고 우측 발에서의 가중침자감각역치는 증상군과 대조군, 그리고 무증상군과 대조군간에서만 통계학적으로 유의한 차이를 나타내었다(p<0.05). 5. 각 부위별 가중침자감각역치와 감각신경의 전도 속도 및 활동전위 진폭과의 상관관계는 측정한 모든 부위에서 통계학적으로 유의한 상관관계를 나타냈다(p<0.05). 이상의 결과로 보아 감각신경 전도검사가 가중침자감각역치보다 정확한 검사이긴 하지만 가중침자감각역치는 말초감각장애 정도를 외래에서 신속히 알고 싶을 때나, 감각신경 전도검사가 불가능한 상황에서 매우 유용한 검사방법이라 생각된다.

• Annals of Clinical Neurophysiology
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• 제10권1호
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• pp.1-12
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• 2008

Intraoperative neuromonitoring (INM) is well known to be useful method to reduce intraoperative complications during the surgery of nervous system lesions. Evoked potentials are most commonly used among the electrophysiological tests. Brainstem auditory evoked potentials are for detecting the problems along the auditory pathways including the eighth cranial nerve and brainstem. Somatosensory evoked potentials are applied for preventing the spinal cord lesions. The INM is affected by many factors. In order to perform an optimal INM, the confounding factors including technical, anesthetical, and individual factors should be kept well under control. INM has frequent electrophysiologic changes during the surgery and it might be helpful to keep one's eyes on which monitoring modalities are reluctant to change during each operation. The skillful monitoring and timely interpretation of electrophysiologic changes can drive the patient to be undergone surgery, even in high surgical risk group.