• 제목/요약/키워드: Nerve conduction

검색결과 290건 처리시간 0.03초

당뇨병성 다발신경병증의 조기 진단에서 신경전도검사의 유용성에 관한 논란 (Controversies on the Usefulness of Nerve Conduction Study in the Early Diagnosis of Diabetic Polyneuropathy)

  • 주인수
    • Annals of Clinical Neurophysiology
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    • 제10권1호
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    • pp.25-28
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    • 2008
  • Diabetic polyneuropathy (DPN) is the most frequently encountered form of neuropathy in diabetic patients, and it either relentlessly progresses or remains relatively stable for many years, not showing any trend towards improvement. From this point of view, early detection of DPN is very important to prevent the irreversible change of the peripheral nerve from diabetic insults. Although a number of clinical symptoms and/or deficit scales have been developed for clinical or research purposes, nerve conduction study (NCS) has been known one of the most objective and sensitive tools to detect peripheral nerve dysfunctions in diabetic patients. NCS, however, also have several shortcomings. The next two consecutive articles will focus on debates about diagnostic usefulness of NCS and on recent updates of other diagnostic tests including quantitative sensory testings and skin biopsy in the field of diabetic polyneuropathy.

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POEMS 증후군의 임상적, 전기생리학적 특성 (Clinical and Electrophysiological Features of the Patients with POEMS Syndrome)

  • 민주홍;홍윤호;이광우
    • Annals of Clinical Neurophysiology
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    • 제6권1호
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    • pp.14-19
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    • 2004
  • Backgrounds and objectives: POEMS (polyneuropathy, organomegaly, endocrinopathy, M protein, and skin changes) syndrome is the rare cause of polyneuropathy. Although the polyneuropathy is essential for the diagnosis of the disease, the pattern of electrodiagnostic abnormalities has not been characterized in detail. The purpose of this study was to elucidate the features of nerve conduction abnormalities in POEMS syndrome. Methods: We reviewed the medical records and nerve conduction studies (NCS) of 12 consecutive patients with POEMS. Results: A total of 68 motor and 46 sensory nerves were examined. Compound muscle action potentials (CMAPs) and sensory nerve action potentials were abnormally attenuated or not elicited in majority of motor and sensory nerves (80.88% in motor, and 82.6% in sensory nerves). Frequency of the nerves with no potential was significantly higher in lower limbs than in upper limbs (p<0.01 in both motor and sensory nerves), and CMAP amplitude was more reduced in lower limbs than in upper limbs (p<0.01). Conduction slowing was very frequently observed with 95% and 76% of motor and sensory nerves, respectively, having the abnormally reduced values of conduction velocity. Distal motor latencies were abnormally prolonged in 75% of motor nerves, and terminal latency indices were significantly higher in patients than in normal controls (p < 0.05). Conduction block was observed only in 5% of motor nerves. Conclusions: NCS in POEMS syndrome showed characteristic patterns, in which conduction abnormalities were more frequently and severely affected in the lower limbs, and more predominantly in the intermediate nerve segments than in the distal portions. The recognition of these characteristic patterns may be helpful in early diagnosis of polyneuropathy in POEMS syndrome.

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정상 성인의 정중지단신경에 대한 전기생리학적 연구 (An Electrophysiologic Study on the Median Digital Nerves in Healthy Adults)

  • 김종순;이현옥;안소윤;구봉오;남건우;류재관;류재문
    • The Journal of Korean Physical Therapy
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    • 제17권3호
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    • pp.329-338
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    • 2005
  • The determination of peripheral nerve conduction velocity is an important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years but normal value of digital nerve was not reported in Korea. To evaluate of digital nerve conduction velocity of median nerve for obtain clinically useful reference value and compare difference in each fingers. 71 normal volunteers(age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II was use for detected conduction velocity and amplitude of digital nerves in median nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation, ANOVA was used to compare each fingers and independent t-test was used to compare between Rt and Lt side also compare between different in genders. Conduction velocity of the right thumb was 49.77m/sec, index finger was 56.80m/sec, middle finger was 56.15m/sec and ring finger was 53.38m/sec. The left thumb was 50.48m/sec, index finger was 56.76m/sec, middle finger was 55.99m/sec and ring finger was 53.23m/sec. Amplitude of the right thumb was $64.30{\mu}V$, index finger was $73.95{\mu}V$, middle finger was $77.97{\mu}V$ and ring finger was $43.92{\mu}V$. The left thumb was $74.21{\mu}V$, index finger was $85.72{\mu}V$, middle finger was $88.06{\mu}V$ and ring finger was $47.28{\mu}V$. There were significantly difference between thumb, index, middle and ring fingers(p<.01) but there were no statistically difference between conduction velocity and amplitude of index and middle fingers(p>.01). The conduction velocity of index finger are faster than other fingers and amplitude of middle finger are greater than other fingers. The present results revealed that electodiagnosis can easily perform in index and middle finger for digital nerve of median nerve study.

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척골 지단 신경의 전기생리학적 연구 (An Electrophysiologic Study on the Ulnar Digital Nerves)

  • 김종순;이현옥;안소윤;구봉오;남건우;김호봉;류재관;류재문
    • 대한정형도수물리치료학회지
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    • 제11권2호
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    • pp.13-18
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    • 2005
  • The ulnar nerve extends down the arm, across the elbow, and into the hand. It provides sensation to the little and ring fingers and activates many of the small muscles in the hand. The determination of peripheral nerve conduction velocity is an important part of ulnar nerve evaluation. The electrodiagnostic value as neurophysiologic investigative procedure has been known for many years but normal value of digital nerve was not reported in Korea. The purpose of this investigation was to measure the digital nerve conduction velocity of ulnar nerve for obtain clinically useful reference value and compare difference in each fingers and then compare with the other countries. 71 normal Korean volunteers (age, 19-65 years; 142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking II (EMG machine) was use for detected conduction velocity and amplitude of digital nerves in ulnar nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation and independent t-test was used to compare with ring and little finger. Conduction velocity of the right ring finger was 57.44m/sec and little finger was 55.32msec. The left ring finger was 55.55msec and little finger was 54.11msec. Amplitude of the right ring finger was $30.28{\mu}V$ and little finger was $48.36{\mu}V$. The left ring finger was $30.67{\mu}V$ and little finger was $52.76{\mu}V$. There were significantly difference between ring and little in amplitude (p<.05) but there were no statistically difference between conduction velocity of ring and little finger (p>.05). The amplitude of little finger are greater than ring finger. The present results revealed that electodiagnosis can easily perform in little finger for digital nerve of ulnar nerve study.

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신경전도와 근전도검사에서의 체온 (Temperature in Nerve Conduction and Electromyography)

  • 김두응
    • Annals of Clinical Neurophysiology
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    • 제8권2호
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    • pp.125-134
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    • 2006
  • Among the various physiological factors that affect nerve conduction velocity (NCV), temperature is the most important. Because the influence of temperature is the most important source of error. It is known from animal experiments that conduction is eventually completely blocked at low temperatures, the myelinated A fibers being the first affected and the thin fibers of group C the last. Many studies showed that the NCV decreases linearly with lowering temperature within the physiological range. The distal motor latency increased by $0.2msec/^{\circ}C$ drop in temperature between $25^{\circ}C$and $35^{\circ}C$ in the median, ulnar and peroneal nerves. The temperature affect the neuromuscular transmission; The miniature endplate potential (MEPP) and endplate potential (EPP) are increase with increasing temperature. In myasthenia gravis, the reduction in the decremental response is observed following cooling. The lowering temperature make increase the amplitude of sensory compound action potential; make enlarge the surface area of compound muscle action potential with very little increase in amplitude; make diminish the fibrillation potential and increase the myotonia in needle electromyography (EMG). Because of these findings mentioned above, the skin temperature should be routinely monitored and controlled during nerve conduction tests and needle EMG and should be taken into account when interpreting the findings.

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

  • 김양호;장미경;신민철
    • The Journal of Korean Physical Therapy
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    • 제18권4호
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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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치과치료용 약물이 치수신경의 반응에 미치는 영향 (EFFECTS OF DENTAL THERAPEUTIC AGENTS ON THE RESPONSE OF THE PULP NERVE)

  • 권오양;윤수한;이종흔
    • Restorative Dentistry and Endodontics
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    • 제15권1호
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    • pp.1-15
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    • 1990
  • The aim of this study was to investigate the effect of dental therapeutic agent on conduction velocity and threshold current of intradental A- and C-fibers in the cat. Inferior alveolar nerve of cat anesthetized with sodium pentobarbital was exposed and dissected until response of functional single pulp nerve until could be evoked by monopolar electrical stimulation of the crown of the lower left canine teeth. 10ms rectangular pulse was used to determine the threshold current and 1ms rectangular pulse was used to determine conduction velocity. After application of calcium chloride (1, 2, 6M), calcium hydroxide mixed with saline, potassium chloride (0.2, 0.8, 1.6M), eugenol, zinc oxide eugenol to the cavity on the labial surface, conduction velocity and threshold current of single pulp nerve unit were compared with the control. In 10 cats, 24 $A{\delta}$- and 11 C- pulp nerve units were recorded. The mean conduction velocities of $A{\delta}$- and C-fibers were 7.5m/sec (SD=5.8) and 1.2m/sec (SD=0.4), respectively. The mean threshold current was $12.3{\mu}A$ (SD=5.3) for $A{\delta}$-fibers and $24.9{\mu}A$ (SD=8.1) for C-fibers. 1, 2, 6M calcium chloride caused decrease of conduction velocity and remarkable increase of threshold current in $A{\delta}$- and C-fibers. The effect of calcium hydroxide mixed with saline was similar but smaller than calcium chloride solution. 0.2M potassium chloride had insignificant effect. In 0.8M potassium chloride, the threshold current was increased although conduction velocity was not affected. In 1.6M potassium chloride, the threshold current was increased and the conduction velocity was slowed down. Spontaneous activity was recorded frequently for first 5 min but gradually reduced both in $A{\delta}$- and C-fibers. Eugenol had irreversible effect on pulp nerve in that initially there were not certain changes in the conduction velocity and threshold current of $A{\delta}$- and C-fibers, but the responses to electrical stimulation were abruptly disappeared after sustained application and were not recovered. Contrary to eugenol, zinc oxide eugenol did not caused significant increase of the threhold current and caused time dependent decrease of the conduction velocity, and did not show any irreversible change.

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손상된 흰쥐의 좌골신경에 저출력 레이저 조사후 전기생리학적 변화 (Electrophysiological Changes after Low-Power Infrared Laser Irradiation on Injured Rat Sciatic Nerves)

  • 배춘식;신수범;김권영
    • 생명과학회지
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    • 제16권1호
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    • pp.114-119
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    • 2006
  • 저출력 적외선 레이저가 손상된 말초신경의 재생에 미치는 영향을 알아보기 위하여 흰쥐의 양측 좌골신경에 압궤손상을 준 뒤, 레이저 조사 기간에 따라 1, 3, 5 및 7주군으로 나누어 손상된 좌골신경의 신경전도속도와 진폭을 측정하여 신경재생의 정도를 관찰한 결과는 다음과 같았다. 좌골신경전도속도 검사에서 압궤손상 유발후에 손상전보다 유의하게 전도속도가 지연되었으나, 레이저를 조사한 실험측은 치료후 3주에 현저하게 신경전도 속도가 증가하였다. 좌골신경 진폭 검사에서 압궤손상 유발후에 손상전보다 유의하게 진폭이 감소하였으나, 레이저를 조사한 실험측은 치료후 3주에 복합근 활동전위의 진폭이 유의하게 증가하였다. 이상의 결과로 보아, 저출력 레이저 조사는 손상된 좌골신경의 기능회복에 있어, 주로 손상 초기의 회복속도에 영향을 주는 것으로 생각되는 바, 향후 말초신경 손상의 재활치료에 고려해야 할 것으로 생각된다.

전남 동부지역에서 손목터널증후군의 수술 전 후 신경전도검사 결과의 평가 (Evaluation of Nerve Conduction Study Result in Carpal Tunnel Syndrome before and after operation in eastern area of Jeonnam)

  • 서충원;김철승
    • 한국산학기술학회논문지
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    • 제13권11호
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    • pp.5305-5310
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    • 2012
  • 본 연구에서 손목터널 증후군의 발생은 손목의 정중 신경 손상에 의한다. 일반적으로 임상 발현 및 신경전도검사를 통해 진단된다. 신경전도검사는 손목터널 증후군 환자 24명을 대상으로 하여 수술 전 후 정중 신경을 비교 평가 하였고, 이중 17명을 대상으로 평가 분석 하였다. 손목터널 증후군 증상의 분석 결과는 전체 환자 수 17명(여:17, 남0), 21손(오른쪽:9, 왼쪽:4, 양쪽:4), 연령(31~60세), 평균 유병 기간 ($46.6{\pm}36.1$), NCS의 첫 번째와 두 번째 검사 간격 개월 수($20.5{\pm}7.1$), 감각 신경(감각 이상:21, 감각 저하:19, 야간통증:17), 운동 신경(무지구 위축:20, 방아쇠 손가락:2, 조조 경직:3), 수술 후 증상은(증상 소실:38.1%, >50% 개선:52.4%, <50% 개선:9.5%) 이었다. 신경전도검사는 수술 후 감각 신경전도검사에서 4명, 운동 신경전도검사에서 5명이 정상 범위 이었다. 수술 전 후의 감각신경활동전위 반응은 이전 결과보다 호전된 결과를 보였다. 앞으로 환자의 직업에 의한 손목터널증후군의 양상과 직업별 수술외적인 치료방법과 수술치료방법을 비교하여 손목터널증후군의 호전정도를 파악하고 정확한 신경전도검사를 통해 환자의 수술여부를 판단해야 된다.

마이크로 컴퓨터를 이용한 운동신경전도속도 측정기의 설계와 제작에 관한 연구 (Design and Development of Motor Nerve Conduction Velocity Measuring Device Based on Microprocessor)

  • 김태욱
    • 대한의용생체공학회:의공학회지
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    • 제10권3호
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    • pp.361-364
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    • 1989
  • A PC-based motor nerve conduction velocity measuring system was designed and constructed. The system was composed with an EMG preamplifier, a stimulator, an Apple II plus microcomputer and an 8 bit AD converter. The system was primariliy intended to screen motor nerve difficulties of industrial workers. This system can acquire, store and display the waveforms of evoked potentials. The PC-based system is expected to increase the versatility and applicability as well as to reduce the system cost.

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