• Title/Summary/Keyword: sensory nerves

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Sensory Complications in Patients after Scalp Mass Excision and Its Anatomical Considerations

  • Yang, Jin Seo;Choi, Hyuk Jai;Cho, Yong Jun;Kang, Suk Hyung
    • Journal of Korean Neurosurgical Society
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    • v.55 no.4
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    • pp.200-204
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    • 2014
  • Objective : To evaluate the incidence of postsurgical sensory complications in patients with scalp masses and classify the locations of them from a surgical standpoint according to anatomical considerations. Methods : A total of 121 patients who underwent surgery for scalp mass were included in this study. The authors reviewed medical records and preoperative radiologic images. We investigated the complications related to sensory changes after procedure. Enrolled patients have been divided into three groups. Group A included patients with tumors above the superior nuchal line (SNL), Group B with tumors within the trapezius muscle area and patients who had tumors on the lateral trapezius muscle area were assigned to Group C. We compared the incidence related to postoperative sensory complications and summarized their additional treatments for these with clinical outcome. Results : There were 12 patients (10%) with sensory complications related on the mass excision site (Group A : 1 patient, Group B : 2 patients, Group C : 9 patients). Six patients were affected with lesser occipital nerve (LON), 2 patients on greater occipital nerve (GON) and 4 patients on GON and LON. Over 6 months after surgery, two of the twelve patients with sensory complications did not have complete recovered pain in spite of proper medications and local chemical neurolysis with 1.0% lidocaine and dexamethasone. Conclusion : Occipital neuropathy should be considered as a complication related excision of scalp mass. The sensory complications are more frequent in Group C because of the anatomical characteristics of the occipital nerves and there were no statistical difference for other variables.

A Case of Acute Motor Conduction Block Neuropathy Associated with Anti-GM1 Antibody (GM1 항체와 연관된 급성 운동 전도차단 신경병증 1예)

  • Park, Kang-Min;Bae, Jong-Seok;Kim, Sang-Jin;Lee, Jeong-Nyeo;Kim, Jong-Kuk
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.89-92
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    • 2007
  • A 33-year-old women developed weakness in all limbs 3 days prior to admission. Motor examination showed decreased strength in all limbs, but sensory examination was normal. Deep tendon reflexes were areflexia. Electrophysiological examination showed conduction blocks with nearly normal conduction velocities and terminal latencies in motor nerves and normal amplitudes and velocities in sensory nerves. Her serum was positive for IgG antibodies to gangliosides GM1, GD1b, and galactocerebroside. Acute motor conduction block neuropathy may be another variant of Guillain-Barre syndrome.

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A Case of Varicella-Zoster virus infection with multiple cranial nerve involvement (다발성 하부뇌신경을 침범한 대상포진 감염 치험 1례)

  • Shin, Jung-Eun;Yoo, Seung-Joo;Kim, Sang-Yoon;Nam, Soon-Yuhl
    • Korean Journal of Bronchoesophagology
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    • v.5 no.2
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    • pp.222-230
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    • 1999
  • Varicella-zoster virus(VZV) becomes latent in the sensory ganglia after primary infection and emerges from latency to cause zoster in adults. After primary infection, VZV remains latent in the dorsal spinal ganglia. The mechanisms responsible for its reactivation and the clinical entity of herpes zoster are poorly understood. Reactivation of VZV is commonly known to manifest as Ramsay Hunt syndrome which is one of the VZV-associated neurologic diseases with facial paralysis, ear pain, and a characteristic herpetic auricular rash. It is now known that lesions of this syndrome can affect all cranial nerves. Central, cervical and peripheral effects of this syndrome is polyneuropathic in nature. VZV usually involves the 5th and 7th cranial nerves and less commonly the lower cranial nerves such as 9th and 10th. We report a treated case of healthy 40 years old male with VZV infection of the 5th, 9th and 10th cranial nerves. The patient typically showed herpetic vesicles in the auricle and temporal bone area without facial paralysis.

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CARE OF POSTTRAUMATIC PAIN SYNDROME IN THE PSYCHIATRIC DISORDER PATIENT : REPORT OF CASES (정신 장애 환자에서 외상후 통증증후군의 관리 : 증례보고)

  • Oh, Ji-Hyeon;Yoo, Jae-Ha;Kim, Jong-Bae
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.11 no.1
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    • pp.9-16
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    • 2015
  • Pain and sensory disorder resulting from injury to peripheral nerves of the face and jaws are a major source of patient dissatisfaction and suffering. The majority of patient who sustain injuries to the peripheral sensory nerves of the face and jaws experience a slow but orderly return of sensation that is functional and tolerable in quality, if not "normal". For many patients, however, the long-term effects are a source of aggravation, and for a few, a significant cause of suffering. Common complaints relate to reduced sensory information causing embarrassing food accumulations or drooling, biting a burning the lip or tongue, and difficulty in performing routine activities such as shaving and apply makeup. For some patients posttraumatic symptoms become pathological and frankly painful. The predominent pain components are (1) numbing anesthesia dolorosa pain, (2) triggered neuralgiaform pain, (3) burning, aching causalgiaform pain, and (4) phantom pain. This is a report of cases about posttraumatic pain syndrome associated with dental treatment in a psychologically disabled patient.

Neurotoxic Desensitizing Effect of Capsaicin on Peripheral Sensory Nerve Endings in Guinea Pig Bronchi (기니픽 기관지 말초신경에 대한 캡사이신의 탈감작 효과)

  • Jung, Yi-Sook;Cho, Tai-Soon;Moon, Chang-Hyun;Shin, Hwa-Sup
    • YAKHAK HOEJI
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    • v.41 no.1
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    • pp.139-146
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    • 1997
  • In the present study, capsaicin-induced desensitization of peripheral sensory nerves were investigated by using guinea pig bronchi, in which these nerves are stimulated with cap saicin to produce a contractile response via the release of sensory neuropeptides such as substance P and neurokinin A. The contractile response to capsaicin was inhibited by the combination of CP96345 and SR 48968 suggesting that the excitatory effect of capsaicin is mediated via both the tachykinin NK-1 and NK-2 receptor. Capsaicin produced in vitro-desensitization in dose-dependent manner, but after this in vitro-desensitization the response to NK-1 and NK-2 receptor agonist did not change. Systemic administration (s.c.) of capsaicin also desensitized significantly bronchial tissues but could not produce any change in the contractile response to the selective agonists of NK-1 and NK-2 receptor. Therefore, the present results suggest that functional desensitization to capsaicin-induced contractile response in guinea pig bronchi does not involve NK-1 and NK-2 receptor, while excitatory effect of capsaicin is mediated via both NK-1 and NK-2 receptor. In conclusion, it is suggested that capsaicin- induced excitation and desensitization involves somewhat different pathways.

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Painful Channels in Sensory Neurons

  • Lee, Yunjong;Lee, Chang-Hun;Oh, Uhtaek
    • Molecules and Cells
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    • v.20 no.3
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    • pp.315-324
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    • 2005
  • Pain is an unpleasant sensation experienced when tissues are damaged. Thus, pain sensation in some way protects body from imminent threat or injury. Peripheral sensory nerves innervated to peripheral tissues initially respond to multiple forms of noxious or strong stimuli, such as heat, mechanical and chemical stimuli. In response to these stimuli, electrical signals for conducting the nociceptive neural signals through axons are generated. These action potentials are then conveyed to specific areas in the spinal cord and in the brain. Sensory afferent fibers are heterogeneous in many aspects. For example, sensory nerves are classified as $A{\alpha}$, $-{\beta}$, $-{\delta}$ and C-fibers according to their diameter and degree of myelination. It is widely accepted that small sensory fibers tend to respond to vigorous or noxious stimuli and related to nociception. Thus these fibers are specifically called nociceptors. Most of nociceptors respond to noxious mechanical stimuli and heat. In addition, these sensory fibers also respond to chemical stimuli [Davis et al. (1993)] such as capsaicin. Thus, nociceptors are considered polymodal. Recent advance in research on ion channels in sensory neurons reveals molecular mechanisms underlying how various types of stimuli can be transduced to neural signals transmitted to the brain for pain perception. In particular, electrophysiological studies on ion channels characterize biophysical properties of ion channels in sensory neurons. Furthermore, molecular biology leads to identification of genetic structures as well as molecular properties of ion channels in sensory neurons. These ion channels are expressed in axon terminals as well as in cell soma. When these channels are activated, inward currents or outward currents are generated, which will lead to depolarization or hyperpolarization of the membrane causing increased or decreased excitability of sensory neurons. In order to depolarize the membrane of nerve terminals, either inward currents should be generated or outward currents should be inhibited. So far, many cationic channels that are responsible for the excitation of sensory neurons are introduced recently. Activation of these channels in sensory neurons is evidently critical to the generation of nociceptive signals. The main channels responsible for inward membrane currents in nociceptors are voltage-activated sodium and calcium channels, while outward current is carried mainly by potassium ions. In addition, activation of non-selective cation channels is also responsible for the excitation of sensory neurons. Thus, excitability of neurons can be controlled by regulating expression or by modulating activity of these channels.

Optic neuritis and multiple cranial neuropathies in patient with chronic inflammatory demyelinating polyneuropathy

  • Bae, Min-Jeong;Lee, Joonwon;Eun, Jeong Ik;Shin, Kyong Jin
    • Annals of Clinical Neurophysiology
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    • v.24 no.2
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    • pp.59-62
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    • 2022
  • Chronic inflammatory demyelinating polyneuropathy (CIDP) is a chronic recurrent acquired immune-mediated disease of the peripheral nerves that presents with progressive sensory and motor deficits in all four limbs. Cranial nerve involvement is not as common as in Guillain-Barre syndrome, and central nervous system involvement including optic neuritis has rarely been reported in patients with CIDP. We recently experienced a case with classic CIDP involving bilateral facial and trigeminal nerves, right lower cranial nerves, and the right optic nerve.

Effect of duration from lingual nerve injury to undergoing microneurosurgery on improving sensory and taste functions: retrospective study

  • Nakanishi, Takashi;Yamamoto, Yuta;Tanioka, Kensuke;Shintani, Yukari;Tojyo, Itaru;Fujita, Shigeyuki
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.61.1-61.8
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    • 2019
  • Background: The prognosis of recovery following microneurosurgery for injured lingual nerves varies among individual cases. This study aimed to investigate if recovery ratios of sensory and taste functions are improved by the microneurosurgery within 6 months after lingual nerve injury. Methods: We retrospectively assessed 70 patients who underwent microneurosurgery at the Wakayama Medical University Hospital for lingual nerve injuries between July 2004 and December 2016. Sensory and taste functions in lingual nerves were preoperatively evaluated using a static two-point discrimination test, an intact superficial pain/tactile sensation test, and a taste discrimination test. They were evaluated again at 12 and at 24 months postoperatively. The abundance ratio of Schwann cells in the excised traumatic neuromas was analyzed with ImageJ software following immunohistochemistry with anti S-100β antibody. Results: In early cases (microneurosurgery within 6 months after the injury), recovery ratios of sensory and taste functions were not significantly different at 24 months after microneurosurgery compared with later cases (microneurosurgery more than 6 months after the injury). Meanwhile, the ratio of patients with taste recovery within 12 months after microneurosurgery was significantly decreased in late cases compared with early cases. The abundance ratio of Schwann cells in traumatic neuroma was also significantly lower in later cases. Conclusion: Microneurosurgery more than 6 months after lingual nerve injury did not lead to decreased recovery ratio of sensory and taste functions, but it did lead to prolonged recovery of taste. This delay may be associated with a decrease in the abundance ratio of Schwann cells in traumatic neuromas.

Sciatic neurotmesis and periostitis ossificans progressiva due to a traumatic/unexpected glass injury: a case report

  • Berkay Yalcinkaya;Hasan Ocak;Ahmet Furkan Colak;Levent Ozcakar
    • Journal of Yeungnam Medical Science
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    • v.41 no.1
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    • pp.45-47
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    • 2024
  • Peripheral nerves may be affected or injured for several reasons. Peripheral nerve damage can result from trauma, surgery, anatomical abnormalities, entrapment, systemic diseases, or iatrogenic injuries. Trauma and iatrogenic injuries are the most common causes. The ulnar, median, and radial nerves are the most injured nerves in the upper extremities, while the sciatic and peroneal nerves are the most injured nerves in the lower extremities. The clinical symptoms of peripheral nerve damage include pain, weakness, numbness/ tingling, and paresthesia. Therefore, early diagnosis and appropriate treatment of peripheral nerve injuries are crucial. If a peripheral nerve injury is left untreated, it can lead to severe complications and significant morbidity. The sciatic nerve is one of the most affected nerves. This nerve is generally injured by trauma and iatrogenic causes. Children are more susceptible to trauma than adults. Therefore, sciatic nerve injuries are observed in pediatric patients. When the sciatic nerve is damaged, pain, weakness, sensory loss, and gait disturbances can occur. Therefore, the diagnosis and treatment of sciatic nerve injuries are important to avoid unexpected consequences. Ultrasound can play an important role in the diagnosis of peripheral nerve injury and the follow-up of patients. The aim of this case report is twofold. First, we aimed to emphasize the critical role of ultrasonographic evaluation in the diagnosis of peripheral nerve injuries and pathologies. Second, we aimed to present this case, which has distinguishing features, such as the existence of periostitis ossificans progressiva with sciatic neurotmesis due to a traumatic glass injury.

Neurophysiology of the Sensory System and Clinical Applications (감각신경계의 신경생리와 임상적 이용)

  • Seo, Dae-Won
    • Annals of Clinical Neurophysiology
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    • v.12 no.2
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    • pp.35-46
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    • 2010
  • Various electrophysiological tests have provided a large body of valuable information on neuronal responses to a presented stimulus. The special and general somatic sensory pathways are main targets of evoked potentials. Two types of evoked potentials, exogenous and endogenous, are commonly used. Exogenous evoked potentials of general and special somatic sensory systems will be reviewed. One of general somatic sensory functional pathways, proprioception, can be evaluated by general somatosensory evoked potentials with electrical stimulation on nerves. The special somatosensory functional pathways, including vision, and audition, can be evaluated by visual evoked potentials and auditory evoked potentials. Also laser-evoked potentials are newly developed for pain pathway, including lateral spinothalamic pathway, and vestibular myogenic evoked potentials for sacculocollic pathways. The evoked potentials of sensory system have maximal clinical utility in evaluating functional deficits along the sensory pathways. They are used for evaluating comatose patients, hysterical patients, premature infants, patients with suspected demyelinating diseases or neoplasms, and research. We discuss the neurophysiologic tests of sensory systems in views of practical points. The organized evaluation of sensory electrophysiologic tests can be helpful in detecting and estimating the abnormalities in neurological diseases.