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Seok-Youl Choi, Jong Woong Park, Dong Hwee Kim
Ultrasonographic study is useful for decision making of treatment for focal neuropathy with unusual electrodiagnostic findings. We present a patient with severe acute radial neuropathy with sensory sparing around the distal arm secondary to twisting of the radial nerve following blunt trauma. A 24-year-old man with a 2-week history of left wrist drop and severe pain around the left elbow presented after hitting the left distal arm on the doorknob. The left wrist and finger extensions were grade 0, but elbow extension could not be tested because of severe pain during this action...
November 2016: American Journal of Physical Medicine & Rehabilitation
Giampietro Zanette, Matteo F Lauriola, Stefano Tamburin
INTRODUCTION: The authors have recently tested a new electrodiagnostic technique for palmar proper digital nerves sensory nerve action potentials in normal controls. Here the authors explored whether it may offer additional information in comparison to mixed nerve wrist stimulation in a series of patients. METHODS: The authors recorded palmar proper digital nerves sensory nerve action potential to selective antidromic webspace stimulation in a group of 19 patients with suspected lesions of median and ulnar nerve hand sensory branches...
October 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Suma Babu, Erik P Pioro, Jianbo Li, Yuebing Li
INTRODUCTION: We compared the yield of limb and thoracic paraspinal muscles for revealing lower motor neuron (LMN) dysfunction on electromyography (EMG) in amyotrophic lateral sclerosis (ALS). METHODS: A retrospective review of 354 patients with clinically definite or probable ALS was performed. Seventeen limb muscles and thoracic paraspinal muscles were evaluated for the presence of both active and chronic denervation. RESULTS: Distal limb muscles showed the highest electrodiagnostic sensitivities of LMN dysfunction in ALS regardless of onset region and diagnostic certainty at the time of diagnosis...
October 19, 2016: Muscle & Nerve
Volkan Solmaz, Selçuk Yavuz, Ahmet İnanr, Dürdane Aksoy, Elmas Pektaş, Aslan Tekataş, Semiha Gulsum Kurt
INTRODUCTION: our aim was to determine if there are electro diagnostic (EDX) differences between carpal tunnel syndrome (CTS) patients with diabetes mellitus (DM), CTS+hypothyroidism (HT), CTS+fibromyalgia (FMS), CTS+rheumatoid arthritis (RA), and idiopathic CTS cases by comparing nerve conduction studies (NCS). METHOD: This research examined electrophysiological studies of untreated 47 HT+CTS, 47 DM+CTS, 49 RA+CTS, 52 FMS+CTS, 50 idiopathic CTS cases, and a healthy control group of 50 individuals (total of 293 patients and 433 hands with CTS)...
October 6, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
Jason Fleming, Dianna Quan
We present a patient with congenital spinal muscular atrophy associated with pain, subjective sensory loss, right talipes equinovarus, delayed walking, and progressive gait impairment. A sister and niece reportedly had Charcot-Marie-Tooth 1A, but the patient's electromyogram showed an axonal motor neuropathy or neuronopathy. We identified a c.806G>A TRPV4 gene mutation causing an Arg269His amino acid substitution. TRPV4 mutations cause variable phenotypes including axonal sensorimotor neuropathy and motor neuropathy or neuronopathy...
September 16, 2016: Neuromuscular Disorders: NMD
Luca Padua, Daniele Coraci, Carmen Erra, Costanza Pazzaglia, Ilaria Paolasso, Claudia Loreti, Pietro Caliandro, Lisa D Hobson-Webb
Carpal tunnel syndrome is the most common peripheral nerve entrapment syndrome worldwide. The clinical symptoms and physical examination findings in patients with this syndrome are recognised widely and various treatments exist, including non-surgical and surgical options. Despite these advantages, there is a paucity of evidence about the best approaches for assessment of carpal tunnel syndrome and to guide treatment decisions. More objective methods for assessment, including electrodiagnostic testing and nerve imaging, provide additional information about the extent of axonal involvement and structural change, but their exact benefit to patients is unknown...
November 2016: Lancet Neurology
Yusuf A Rajabally, Fu Liong Hiew
INTRODUCTION: The most efficient method of performing electrophysiology for Guillain-Barré syndrome (GBS) is unknown. METHODS: We retrospectively analyzed electrophysiological data of 97 consecutive GBS patients from Birmingham, U.K. (2001-12) studied ≤3 weeks post-onset. RESULTS: The sensitivity of electrophysiology for each GBS subtype was dependent on the tested upper and lower limb nerves. In acute inflammatory demyelinating polyneuropathy (AIDP), abnormalities were predominant in the arms, whereas leg abnormalities predominated in axonal GBS...
October 17, 2016: Muscle & Nerve
Rahul Dwivedi, Sambath Tiroumal
PURPOSE: Paclitaxel (Taxol) is a microtubule-stabilizing agent and belongs to the taxane group of chemotherapeutic drugs. It is used to treat numerous malignancies, such as breast and lung cancers. A rare side effect of this drug includes cystoid macular edema (CME), which is presumed to resolve after cessation of Paclitaxel. We present a case of topical Dorzolamide 2% (Trusopt) having a possible successful effect in the treatment of Paclitaxel-related nonresolving CME. By highlighting this rare ocular side effect of a common chemotherapeutic agent, which fails to resolve upon cessation of the drug alone, we suggest a possible treatment that may help other ophthalmologists in their management of similar cases...
October 4, 2016: Retinal Cases & Brief Reports
Fariba Eslamian, Bina Eftekharsadat, Arash Babaei-Ghazani, Fateme Jahanjoo, Mojgan Zeinali
INTRODUCTION: The aim of this study was to compare the clinical and electrodiagnostic efficacy of ultrasound (US) guided vs. landmark (LM) guided steroid injections in patients with carpal tunnel syndrome (CTS). METHODS: This randomized clinical trial included 47 patients (60 affected hands) with moderate CTS (30 hands in each group). All clinically suspected CTS patients who met the inclusion criteria confirmed by electrodiagnostic tests were enrolled. The subjects received 40mg of methylprednisolone either with the US-guide or the LM -guide injection technique...
October 1, 2016: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
A Arturo Leis, Dobrivoje S Stokic
Worldwide concern over Zika virus causing Guillain-Barre syndrome (GBS) soared after recent reports that Zika-related weakness was due to GBS. A global strategic response plan was initiated with recommendations for at-risk countries to prepare for GBS. This plan has major economic implications, as nations with limited resources struggle to implement costly immunotherapy. Since confirmation of causality is prerequisite to providing specific management recommendations, it is prudent to review data endorsing a GBS diagnosis...
2016: Frontiers in Neurology
Hyun Ho Shin, Young Hoon Jeon, Seung Won Jang, Sae Young Kim
Muscular hypertrophy is caused mainly due to myopathic disorder. But, it is also rarely produced by neurogenic disorder. A 74-year-old woman complained of right calf pain with hypertrophy for several years. Recent lumbar spine magnetic resonance imaging (MRI) showed central and lateral canal narrowing at the L4-L5 intervertebral space. Lower extremity MRI revealed fatty change of right medial head of the gastrocnemius and soleus, causing right calf hypertrophy. Electrodiagnostic examinations including electromyography and nerve conduction velocity testing demonstrated 5(th) lumbar and 1(st) sacral polyradiculopathy...
October 2016: Korean Journal of Pain
Benson J Pulikkottil, Micah Schub, Tiffany R Kadow, William Wang, John R Fowler
PURPOSE: To determine whether there is a correlation between the cross-sectional area (CSA) of the median nerve, as measured using ultrasound, and the distal motor and/or sensory latencies as measured on nerve conduction studies. METHODS: Patients with clinical signs and symptoms of carpal tunnel syndrome were prospectively enrolled in this study. Subjects underwent ultrasound measurement of the CSA of the median nerve at the carpal tunnel inlet by a fellowship-trained hand surgeon, followed by nerve conduction studies (NCS) by a certified electrodiagnostic technician who was blinded to the results of the ultrasound examination...
October 2016: Journal of Hand Surgery
Mark A Ferrante, Asa J Wilbourn
INTRODUCTION: The muscles commonly affected by neuralgic amyotrophy (NA) are well known, but the location of the responsible lesions is less clear (plexus versus extraplexus). METHODS: We report the lesion locations in 281 NA patients as determined by extensive electrodiagnostic (EDX) testing. RESULTS: Our 281 patients had 322 bouts of NA, 57 of which were bilateral, for a total of 379 assessable events. A single nerve was involved in 174 (46%), and 205 (54%) were multifocal...
September 28, 2016: Muscle & Nerve
Zachary N London
Discomfort is an unavoidable part of electrodiagnostic (EDX) studies. The most readily modifiable mediator of electromyography (EMG)-associated pain is muscle selection. Interventions that may reduce pain include vapocoolant spray, ibuprofen, and techniques such as slapping or stretching the skin. Needlestick injuries to health care workers carry the risk of transmitting bloodborne illnesses, but other Infectious complications of EDX studies are very rare. EMG probably contributes to asymptomatic hemorrhage in about 1% of patients, but clinically significant bleeding has only been reported a few times...
September 28, 2016: Muscle & Nerve
Sameh Ghroubi, Samar Alila, Atika Mallek, Wafa Elleuch, Khlil Nouri, Mohamed Habib Elleuch
OBJECTIVE: To show the contribution of the sensory nerve action potential in the topographic diagnosis of traumatic brachial plexus injuries through an illustration of 7 clinical cases. OBSERVATIONS: We report 7 clinical cases of patients with unilateral traumatic brachial plexus injuries, following public highway accident. We realized an electroneuromyographic test (ENMG) for each patient in our service. A radiculopathy C5C6C7 were found in 3 subjects. Other patients had a radiculopathy C5 T1, a radiculopathy C7C8 T1, a lesion of the upper trunk or a lesion of the posterior cord...
September 2016: Annals of Physical and Rehabilitation Medicine
Adam Lewno, Wendy Helkowski
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Yong-Soon Yoon, Kwang-Jae Lee, Eun-Sil Kim, Ji-Hyun Jeon
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Ingrid Vasconcellos Faber, Joana Rosa Marques Prota, Alberto Rolim Muro Martinez, Anamarli Nucci, Iscia Lopes-Cendes, Marcondes Cavalcante França Júnior
INTRODUCTION: Chediak-Higashi syndrome (CHS) is a very rare autosomal recessive disorder (gene CHS1/LYST) characterized by partial albinism, recurrent infections, and easy bruising. Survivors develop a constellation of slowly progressive neurological manifestations. METHODS: We describe clinical, laboratory, electrophysiological, and genetic findings of a patient who developed an immune-mediated demyelinating neuropathy as the main clinical feature of CHS. RESULTS: The patient presented with subacute flaccid paraparesis, absent reflexes, and reduced vibration sense...
September 26, 2016: Muscle & Nerve
Uma Sundar, Sanjay Gulhane, D Asole
Lambert Eaton myasthenic syndrome is a presynaptic neuromuscular junction disorder, which has unique features on electrodiagnostic testing. Here we describe a middle aged lady with symmetric, progressive, areflexic weakness in lower limbs, who had the typical electrodiagnostic findings of diffuse attenuation of motor amplitudes, and increase in these amplitudes after brief exercise of the muscle sampled.
December 2015: Journal of the Association of Physicians of India
Matthew R Kaufman, Andrew I Elkwood, David Brown, John Cece, Catarina Martins, Thomas Bauer, Jason Weissler, Kameron Rezzadeh, Reza Jarrahy
Background Phrenic nerve reconstruction has been evaluated as a method of restoring functional activity and may be an effective alternative to diaphragm plication. Longer follow-up and a larger cohort for analysis are necessary to confirm the efficacy of this procedure for diaphragmatic paralysis. Methods A total of 180 patients treated with phrenic nerve reconstruction for chronic diaphragmatic paralysis were followed for a median 2.7 years. Assessment parameters included: 36-Item Short Form Health Survey (SF-36) physical functioning survey, spirometry, chest fluoroscopy, electrodiagnostic evaluation, a five-item questionnaire to assess specific functional issues, and overall patient-reported outcome...
September 25, 2016: Journal of Reconstructive Microsurgery
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