• 대한임상검사과학회지
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• 제53권2호
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• pp.151-157
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• 2021

선천성 유전질환인 CMT와 후천성 면역 매개 질환인 CIDP는 임상적 증상이 유사하므로 두 질환의 감별진단을 위해서는 말초신경의 전기생리학적 특징을 비교하는 것이 도움이 될 수 있다. 본 연구는 CIDP와 CMT 1형으로 확진된 환자의 신경전도검사 결과 중 감각신경전도검사의 주요 지표별 결과를 후향적으로 정량분석하여 두 질환군의 전기생리학적 특징을 규명하고자 하였다. CIDP (N=35)와 CMT1 (N=30)로 확진된 환자의 dCNAP와 SNCV를 이용하여 두 질환군의 중증도 분석, 유의성 검정, 비정상 범위별 비율분석 및 상관분석을 실시하여 통계적 차이를 기반으로 특징을 비교하였다. 두 질환 모두 전신성 말초신경다발신경병증의 특징이 관찰되었고, 장딴지신경의 손상이 가장 심한 것으로 확인되었다. CMT1군은 탈수초성 및 축삭성 신경병증을 동반하는 전신성 신경병증이고, CIDP보다 더 중증의 신경병증임이 확인되었다. 또한, 상관계수 및 산점도 분석에서 CMT1은 신경 손상 범위가 전체 신경에서 균등한 전기생리학적 특징이 관찰되었다. 감각신경전도검사의 결과를 기반으로한 본 연구결과가 CIDP와 CMT 1형의 감별진단 및 연구에 도움이 될 것으로 사료된다.

• Annals of Clinical Neurophysiology
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• 제16권1호
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• pp.21-26
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• 2014

Background: Electrophysiological study has been known as a useful method to evaluate the therapeutic effect of operation in idiopathic carpal tunnel syndrome (CTS). The purpose of this study was to evaluate the clinical and electrophysiological changes after carpal tunnel release (CTR) compared to the preoperative results. Methods: We analyzed the changes of nerve conduction study (NCS) before and after minimal open carpal tunnel release in 18 patients (25 hands) with CTS. Follow-up study was performed over 6 months after operation. Results: Clinical improvement was seen in all cases after CTR. In contrast, electrophysiological improvement was various depending on the parameters; the mean median sensory latency and nerve conduction velocity (NCV) improved significantly (p = 0.001). The mean median motor latency also improved, but NCV and compound muscle action potential (CMAP) amplitude did not change. The extent of improvement was evident in moderate CTS, but not in severe CTS. Conclusions: In this preliminary study, all subjects who underwent CTR achieved a clinical relief along with a significant improvement of electrophysiological parameters such as median sensory latency, sensory NCV and median distal motor latency. After CTR, a number of cases with mild to moderate CTS showed a prominent improvement of clinical and electrophysiological parameters, while fewer improvements were seen in severe CTS, although it did not reach the statistical significance.

• Journal of Genetic Medicine
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• 제17권2호
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• pp.89-91
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• 2020

Charcot-Marie-Tooth (CMT) disease can be divided mainly into demyelination and axonopathy based on the results of the electrophysiological study. Mitofusin 2, encoded by MFN2 gene, has a crucial role in the fusion of mitochondria, which is known to associate with CMT type 2A as one of the axonal forms. We describe a 44-year-old man with progressive weakness on bilateral legs after noticing foot drop in his early teen. When we examined him at 45 years of age, he presented atrophy on entire legs and with distal muscle weakness on limbs. The nerve conduction study revealed severely decreased amplitude on motor nerve ranging from 0.2 to 4.5 mV, while conduction velocity remained more than 30.4 m/s. The whole-exome sequencing revealed a novel variant c.2228G>T in MFN2 by efficient genetic analysis tool, MutationDistiller. This report will not only expand the mutation spectrum of CMT2A but also introduce a time-saving genetic analysis tool.

• Annals of Clinical Neurophysiology
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• 제20권2호
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• pp.101-104
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• 2018

Multifocal acquired demyelinating sensory and motor (MADSAM) neuropathy is a variant of chronic acquired demyelinating polyneuropathy. A 65-year-old women presented with upper arm weakness. A nerve conduction study showed conduction blocks over intermediate segments with sparing of distal compound action potentials. Magnetic resonance imaging revealed asymmetric hypertrophy of the brachial plexus on the affected side. These findings represent important electrophysiological and radiological evidence of MADSAM neuropathy. The condition of the patient began to improve after starting intravenous immunoglobulin administration.

• The Korean Journal of Physiology and Pharmacology
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• 제2권1호
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• pp.9-19
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• 1998

The present study was primarily carried out to characterize the properties of the spinomesencephalic tract (SMT) neurons that project from the upper cervical spinal segments to the midbrain. It was also investigated whether these neurons received convergent afferent inputs from other sources in addition to cervical inputs. Extracellular single unit recordings were made from neurons antidromically activated by stimulation of midbrain. Recording sites were located in lamina $I{\sim}VIII\;of\;C1{\sim}C3$ segments of spinal cord. Receptive field (RF) and response properties to mechanical stimulation were studied in 71 SMT neurons. Response profiles were classified into six groups: complex (Comp, n=9), wide dynamic range (WDR, n=16), low threshold (LT, n=5), high threshold (HT, n=6), deep/tap (Deep, n=10), and non- responsive (NR, n=25). Distributions of stimulation and recording sites were not significantly different between SMT groups classified upon their locations and/or response profiles. Mean conduction velocity of SMT neurons was $16.7{\pm}1.28\;m/sec$. Conduction velocities of SMTs recorded in superficial dorsal horn (SDH, n=15) were significantly slower than those of SMTs recorded in deep dorsal horn (DDH, n=18), lateral reticulated area (LRA, n=21), and intermediate zone and ventral horn (IZ/VH, n=15). Somatic RFs for SMTs in LRA and IZ/VH were significantly larger than those in SDH and DDH. Five SMT units (4 Comps and 1 HT) had inhibitory somatic RFs. About half (25/46) of SMT units have their RFs over trigeminal dermatome. Excitabilities of 5/12 cells and 9/13 cells were modulated by stimulation of ipsilateral phrenic nerve and vagus nerve, respectively. These results suggest that upper cervical SMT neurons are heterogenous in their function by showing a wide range of variety in location within the spinal gray matter, in response profile, and in convergent afferent input.

• Annals of Clinical Neurophysiology
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• 제23권2호
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• pp.99-107
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• 2021

Background: Pain and autonomic dysfunction are prominent symptoms in some patients with carpal tunnel syndrome (CTS). Infrared thermography (IRT) has been used to evaluate CTS by measuring the cutaneous temperature and sympathetic vasomotor function. Methods: This study enrolled the 66 hands of 33 subjects, some of which had clinical CTS and the others were healthy. The enrolled patients completed the Boston Carpal Tunnel Questionnaire (BCTQ) and Historical-Objective scale, and underwent nerve conduction studies (NCSs) and IRT. Skin temperature was measured at the fingertips and the thenar and hypothenar regions in each hand. We analyzed (1) the correlations between self-reported severity, physician-assessed severity, and test results, and (2) the sensitivity and specificity of IRT in diagnosing CTS. Results: No significant correlation was observed between the results of the BCTQ, NCS, and IRT. IRT had a low sensitivity and high specificity in diagnosing CTS. Conclusions: IRT cannot replace NCS in diagnosing CTS, nor did it provide an advantage in combination with NCS. However, lower temperatures at the median nerve in some hands with moderate-to-severe CTS suggested the involvement of sympathetic nerve fiber function. Follow-up studies with a larger-scale and complementary design are required to elucidate the relationships.

• Korean Journal of Radiology
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• 제23권2호
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• pp.237-245
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• 2022

Objective: Viscoelasticity is an essential feature of nerves, although little is known about their viscous properties. The discovery of shear wave dispersion (SWD) imaging has presented a new approach for the non-invasive evaluation of tissue viscosity. The present study investigated the feasibility of using SWD imaging to evaluate diabetic neuropathy using the sciatic nerve in a diabetic rat model. Materials and Methods: This study included 11 diabetic rats in the diabetic group and 12 healthy rats in the control group. Bilateral sciatic nerves were evaluated 3 months after treatment with streptozotocin. We measured the nerve cross-sectional area (CSA), nerve stiffness using shear wave elastography (SWE), and nerve viscosity using SWD imaging. The motor nerve conduction velocity (MNCV) was also measured. These four indicators and the histology of the sciatic nerves were then compared between the two groups. The performance of CSA, SWE, and SWD imaging in distinguishing the two groups was assessed using receiver operating characteristic (ROC) analysis. Results: Nerve CSA, stiffness, and viscosity in the diabetic group was significantly higher than those in the control group (all p < 0.05). The results also revealed a significantly lower MNCV in the diabetic group (p = 0.005). Additionally, the density of myelinated fibers was significantly lower in the diabetic group (p = 0.004). The average thickness of the myelin sheath was also lower in the diabetic group (p = 0.012). The area under the ROC curve for distinguishing the diabetic neuropathy group from the control group was 0.876 for SWD imaging, which was significantly greater than 0.677 for CSA (p = 0.030) and 0.705 for SWE (p = 0.035). Conclusion: Sciatic nerve viscosity measured using SWD imaging was significantly higher in diabetic rats. The viscosity measured using SWD imaging performed well in distinguishing the diabetic neuropathy group from the control group. Therefore, SWD imaging may be a promising method for the evaluation of diabetic neuropathy.

• Journal of Acupuncture Research
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• 제41권2호
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• pp.121-128
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• 2024

This study presents a case of facial nerve injury that occurred after parotidectomy for a benign tumor of the parotid gland that improved with integrated Korean medicine (IKM). On June 24, 2023, the patient presented with facial nerve injury based on a facial nerve conduction study after parotidectomy, with a score of five on Yanagihara's unweighted grading system (Y-system) and a grade of five on the House-Brackmann facial grading scale (H-B scale). During the 15 days of admission, IKM treatments, including acupuncture, pharmacopuncture, moxibustion, herbal steam therapy, physiotherapy, herbal medicine, and thread embedding acupuncture treatment, were performed. After treatment, the strength of the orbicularis oculi, orbicularis oris, and masticatory muscles improved, with a Y-system score of 17 and an H-B scale of III. In conclusion, the findings of this study confirm the applicability and effectiveness of IKM in the treatment of facial paralysis following parotidectomy.

• 대한물리치료과학회지
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• 제4권2호
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• pp.433-438
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• 1997

This study has done to show the analysis and ressult of their recovery in 35 cases of peripheral paralysis of the facial nerve. The research was from Jan. 1, 1994 to Dec. 31, 1996 at Ulsan Dong Kang Hospital. The results were as follows ; 1. There were 19 males(54.3%) and 16 females(45.7%). Age distribution of patients showed above 20 years old in 31 patients(88.6%). 2. 18 cases(51.4%) were on the right and 17 cases(48.6%) on the left side. 3. Unknown of etiology was 23 cases(65.7%). 4. Grade of injury was zero in 21 cases(60.0%), trace in 8 cases(22.9%). 5. The period of treatment was $2{\sim}3$ weeks in 23 cases(65.7%), $1{\sim}2$ months in 3 cases(8.6%). 6. On electromyography facial nerve action potential amplitude was above 1.0 mv in 22 patients(62.9 %) after treatment. Facial nerve conduction latency using orbicularis oris was below 6.0 msec in 23 patients(65.7%) after treatment. 7. Recovery of patient was normal in 25 cases(71.5%) and fair in 10 cases(28.5%).

• Annals of Clinical Neurophysiology
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• 제4권1호
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• pp.78-80
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• 2002

A 32-year-old man who had worked at aluminum processing plant for 4 months visited us. He complained of numbness and paresthesia of both foot and hands and weakness of all extremities. Electrophysiologic study showed motorsensory polyneuropathy of diffuse axonal type with focal conduction block. And we discovered higher concentration of n-Hexane in his workplace. On sural nerve biopsy, bubbly enlarged nerve fibers in light microscope and thick myelin sheath and axonal degeneration on electron microscope were found. We diagnosed it as n-Hexane induced neuropathy.