• 농촌의학ㆍ지역보건
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• 제24권1호
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• pp.1-11
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• 1999

본 연구는 농약에 직업적으로 폭로되고 있는 농부들의 말초신경 기능을 평가하고자 농약살포 남성 농민 34명을 대상으로, 1998년 5월부터 1999년 2월에 걸쳐 실시하였다. 연구내용으로는 말초신경병변을 평가하기 위한 방법으로 현재 가장 많이 사용되고 있는 신경전도 검사를 우세 상하지의 청중신경, 척골신경, 비골신경, 후경골신경, 비복신경 대해 각 구간별로 나누어 실시하였다. 조사결과 조사대상자들은 평균 60세로서 농약살포 경력은 평균 33년이었다. 농사 유형은 주로 논, 밭, 고추 농사를 경작하고 있었으며 년간 평균 약 35일간 농약을 살포하였고 1일 살포시간은 약 9시간이었다. 또한 농약 중독 관련 증상을 경험한 적이 약 82%이상에서 보고되었다. 신경전도 검사상 조사원 모든 신정에서의 값이 정상범위에는 포함되었지만, 일부구간(척골감각 신경의 wrist-elbow, 후경골신경의 terminal latency)을 제외하고는 모두 참고치의 평균값보다 유의하게 낮은 것으로 나타났다. 또한 상대적 고폭로군과 저폭로군 간의 신경전도 검사치 비교에 의하면 정중감각 및 운동, 비골신경의 일부 구간 값이 고폭로군에서 높은 것을 제외하고는 유의한 차이를 발견할 수 없었다. 이것은 고폭로군의 연령이 저폭로군보다 유의하게 낮기 때문으로 판단되며, 조사 대상자들의 값이 참고치 평균보다 떨어진 것도 연령이 높음으로 인한 것임을 연령군별 비교에 의해 확인할 수 있었다. 따라서 향후 농약 폭로로 인한 미세한 말초신경 기의 이상여부를 조기에 파악하기 위해서는 감각역치 검사등 다론 신경학적 검사들을 함께 실시하는 것이 바람직하다고 판단되었다.

• Annals of Clinical Neurophysiology
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• 제4권2호
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• pp.125-132
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• 2002

Objectives : Although the diagnosis of hereditary neuropathy with liability to pressure palsies (HNPP) is important for correct prognostic evaluation and genetic counseling, the diagnosis is frequently missed or delayed. Our main aim on undertaking this study was to characterize the electrodiagnostic features of HNPP. Material and Methods : Clinical, electrophysiologic and molecular studies were performed on Korean HNPP patients with 17p11.2 deletion. The results of electrophysiologic studies were compared with those of Charcot-Marie-Tooth disease type 1A (CMT1A) patients carrying 17p11.2 duplication. Results : Eight HNPP (50 motor, 39 sensory nerves) and six CMT1A (28 motor, 16 sensory nerves) patients were included. The slowing of sensory conduction in nearly all nerves and the distal accentuation of motor conduction abnormalities are the main features of background polyneuropathy in HNPP. In contrast to CMT1A, where severity of nerve conduction slowing was not different among nerve groups, HNPP sensory nerve conduction was more slowed in the median and ulnar nerves than in the sural nerve (p<0.01), and DML was more prolonged in the median nerve than in the other motor nerves (p<0.01). TLIs were significantly lower in HNPP than in the normal control and CMT1A patients for the median and ulnar nerves (p<0.01), and were also significantly reduced for the peroneal nerve (p<0.05) compared with those of the normal controls. Conclusion : The distribution and severity of the background electrophysiologic abnormalities are closely related to the topography of common entrapment or compression sites, which suggests the possible pathogenetic role of subclinical pressure injury at these sites in the development of the distinct background polyneuropathy in HNPP.

• Journal of Preventive Medicine and Public Health
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• 제39권5호
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• pp.404-410
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• 2006

Objectives: This study examined the natural history of symptomatic patients who did or did not display abnormal results on nerve conduction studies (NCS). Methods: Forty hundred fifty adults were selected among a total of 578 residents who participated in the health examination in a rural Korean district. A symptom questionnaire and NCS were used to diagnose ulnar neuropathy at the elbow (UNE). There were 6.4% of the subjects with UNE, 5.1 % of the subjects showed symptoms without a NCS, and 84.2% of the subjects who were asymptomatic. One year later, 20 symptomatic limbs with an abnormality on the ulnar NCS and 22 symptomatic limbs without any abnormality in the ulnar NCS were enrolled in a follow-up study. The natural history of UNE was evaluated by examining the changes in the clinical and electrodiagnostic examinations. Results: The 1-year follow-up of the enrolled limbs found that for the symptomatic limbs with an abnormality on the NCS, the degree of severe of the clinical grade changed from 20% to 10%. In contrast, for the symptomatic limbs that were without any abnormality in the NCS, the change of the severe degree of the clinical grade was from 0% to 18.2%. Also, for the electrodiagnostic change, only symptomatic limbs without NCS abnormalities showed significant changes in motor latency, amplitude and conduction velocity at the 1-year follow-up. Conclusions: The 1-year follow-up study revealed symptomatic limbs that were without any abnormality on the ulnar NCS were more likely to progress than the symptomatic limbs with an abnormality on the ulnar NCS.

• 대한의생명과학회지
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• 제17권4호
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• pp.313-319
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• 2011

Diabetes mellitus (DM) leads to a variety of complications and thus we have retrospectively studied to investigate problems of nerve conduction velocity (NCV) study and the heart in the patients with type-II DM. Blood glucose and blood pressure levels were higher in DM group than in Non-DM group. We found that several latencies were delayed in motor conduction study of upper (median and ulnar nerve) and lower extremities (peroneal and tibial nerve), whereas amplitudes and NCVs were decreased in DM group compared with Non-DM group. Latencies of sensory conduction study in upper and lower extremities (sural nerve) were delayed, while amplitudes and NCVs were lower in DM group than in Non-DM group. Abnormal percent of the electrocardiogram was higher in DM group than in Non-DM group. This retrospective study suggests that type-II DM can cause a damage effect on the peripheral nerve and the heart function.

• Journal of Yeungnam Medical Science
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• 제6권1호
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• pp.151-163
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• 1989

건강한 성인 83명을 무작위로 선정하여 실시한 신경전도속도 검사에서 다음과 같은 결과를 얻었다. 1) 상지의 정중신경에서는 운동신경의 TL이 3.0-4.2msec 이고, MNCV는 각각 52.1-70.3m/sec(W-E), 44.6-71.0m/sec(E-Ax), 56.6-70.8m/sec(W-E), 50.5-75.1m/sec(E-Ax)이며, CNAP의 진폭은 $6.5-46.1{\mu}V$였다. 2) 척골신경에서는 운동신경의 TL이 2.4-3.4msec이고, MNCV는 각각 54.6-72.8m/sec(W-E), 41.1-64.9m/sec(E-Ax)이며, 진폭은 3.1-12.0mV였다. 척골신경의 MNCV는 각각 31.1-44.7m/sec(F-W)m, 55.9-70.9m/sec(W-E), 46.9-67.1m/sec(E-Ax)이며, CNAP의 진폭은 4.8-42.9${\mu}V$범위였다. 3) 요골신경에서는 운동신경의 TL이 1.9-2.7msec이고, MNCV는 53.1-77.5m/sec(W-E)이며, CMAP의 진폭은 1.1-6.6mV범위였다. 요골신경의 SNCV는 각각 38.5-52.1m/sec(F-V), 53.2-75.2m/sec(W-E) 이며, CNAP의 진폭은 $2.5-9.2{\mu}V$범위였다. 4) 하지의 비골신경에서는 운동신경의 TL이 3.5-5.7msec이며, MNCV는 각각 44.4-58.6m/sec(A-FH), 42.8-65.8m/sec(FH-PF)이며, CMAP의 진폭은 0.6-12.7mV 범위였다. 5) 후경골신경에서는 TL이 4.0-6.2m/sec이며, MNCV는 40.6-60.6m/sec이며, CMAP의 진폭은 3.9-29.2mV범위였다. 6) 비골신경의 SNCV는 37.5-49.5m/sec이며, CNAP의 진폭은 $0.7-17.1{\mu}V$범위였다. 7) H-반사의 평균 잠복기는 28.4msec였다.

• Annals of Clinical Neurophysiology
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• 제21권1호
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• pp.36-43
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• 2019

Background: Diabetic peripheral polyneuropathy (DPN) is associated with a variety of symptoms. Nerve conduction studies (NCSs) are considered to be the gold standard of nerve damage assessments, but these studies are often dissociated from the subjective symptoms observed in DPN patients. Thus, the aim of the present study was to investigate the correlations between NCS parameters and neuropathic symptoms quantified using the Michigan Neuropathy Screening Instrument (MNSI). Methods: Patients with type 2 diabetes mellitus (T2DM) with or without symptoms of neuropathy were retrospectively enrolled. Demographic data, clinical laboratory data, MNSI score, and NCS results were collected for analysis; DPN was diagnosed based on the MNSI score (${\geq}3.0$) and abnormal NCS results. Pearson's correlation coefficients were used to evaluate the relationships between MNSI score and NCS variables. Results: The final analyses included 198 patients (115 men and 83 women) with a mean age of $62.6{\pm}12.7$ years and a mean duration of diabetes of $12.7{\pm}8.4$ years. The mean MNSI score was 2.8 (range, 0.0-9.0), and 69 patients (34.8%) were diagnosed with DPN. The MNSI score was positively correlated with the median motor nerve latency and negatively correlated with the median motor, ulnar sensory, peroneal, tibial, and sural nerve conduction velocities (NCVs). When the patients were categorized into quartiles according to MNSI score, peroneal nerve conduction velocity was significantly lower in the second MNSI quartile than in the first MNSI quartile (p = 0.001). A multivariate analysis revealed that the peroneal NCV was independently associated with MNSI score after adjusting for age, sex, and glycosylated hemoglobin A1c (HbA1c) levels. Conclusions: The present results indicate that a decrease in peroneal NCV was responsible for early sensory deficits in T2DM patients.

• Annals of Clinical Neurophysiology
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• 제12권1호
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• pp.11-15
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• 2010

Background: In belly-tendon (bipolar) montage, reference (R2) electrode placed on muscle's tendon has traditionally been considered to be electrically inactive. However, recent studies have revealed that R2 electrode is not simply referential, but actively contributes to compound muscle action potential (CMAP) waveform morphology. These findings suggest that CMAP onset latency and amplitude may also be influenced by the position of R2 electrode. This study was performed in order to evaluate the effect of R2 electrode position on CMAP onset latency and amplitude. Methods: We performed motor nerve conduction studies of median, ulnar, tibial and peroneal nerves on bilateral limbs of 20 normal subjects. We used traditional bipolar and monopolar montage and compared their CMAP onset latencies and amplitudes. In bipolar montage, recording (R1) electrode was placed on mid-belly of muscle with R2 electrode on the tendon of the muscle. In monopolar montage, R1 electrode was placed on the same site of bipolar montage, while R2 electrode was placed on the contralateral limb. Results: The mean CMAP onset latencies of median and peroneal nerves in bipolar montage were significantly different (p<0.05) with those in monopolar montage. And those of ulnar and tibial nerves were not significantly different (p>0.05). The mean CMAP amplitudes of all the tested nerves except ulnar nerve were significantly different (p<0.05). Conclusions: This study shows that change in R2 electrode position can affect the CMAP onset latency and amplitude, and these differences seem to be related to the generation of far field potential by CMAP.

• Annals of Clinical Neurophysiology
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• 제8권1호
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• pp.102-105
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• 2006

We present a case with stepwise weakness and sensory involvement of both hands for more than 2 months. His nerve conduction study findings revealed prolonged terminal latencies, decreased motor and sensory conduction velocities and conduction blocks of both ulnar nerves, more severely on left side. And there were other abnormalities manifested with mononeuropathy multiplex. Increased cerebrospinal fluid protein was found. We diagnosed him as Lewis-Sumner syndrome and tried high dose oral steroid therapy for 2 months. He showed improvement of motor functioning with persistent conduction block.

• 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.

• Annals of Clinical Neurophysiology
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• 제3권2호
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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.