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Ida K Fox, Christine B Novak, Emily M Krauss, Gwendolyn M Hoben, Craig Zaidman, Rimma Ruvinskaya, Neringa Juknis, Anke C Winter, Susan E Mackinnon
BACKGROUND: Nerve transfer surgery to restore upper extremity (UE) function in cervical spinal cord injury (SCI) is novel and may transform treatment. Determining candidacy even years post-SCI is ill-defined and deserves investigation. OBJECTIVE: To develop a diagnostic algorithm, focusing on electrodiagnostic studies (EDX), to determine eligibility for nerve transfer surgery. DESIGN: Retrospective descriptive case series SETTING: Tertiary university-based institution PATIENTS: Individuals with cervical SCI (n = 45) METHODS: The electronic medical records of people referred to the Plastic and Reconstructive Surgery UE Surgery in SCI clinic from 2010-2015 were reviewed...
March 15, 2018: PM & R: the Journal of Injury, Function, and Rehabilitation
Jeffrey A Allen, Kenneth C Gorson, Deborah Gelinas
Introduction: We explored adherence to the European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) guidelines for the diagnosis and treatment of chronic inflammatory demyelinating polyneuropathy (CIDP) by reviewing data from a specialty pharmacy database. Materials and Methods: Clinical and electrophysiologic data were reviewed for 65 consecutive patients treated with intravenous immunoglobulin (IVIG) for CIDP. Three neuromuscular neurologists independently classified cases according to EFNS/PNS criteria as (1) fulfilling CIDP criteria; (2) non-CIDP (neither clinical nor electrophysiologic criteria met); or (3) unknown (insufficient information)...
March 2018: Brain and Behavior
Ruben Jauregui, Galaxy Y Cho, Vitor K L Takahashi, Julia T Takiuti, Alexander G Bassuk, Vinit B Mahajan, Stephen H Tsang
Inherited retinal diseases (IRDs) are a major cause of incurable familial blindness in the Western world. In the pediatric population, IRDs are a major contributor to the 19 million children worldwide with visual impairment. Unfortunately, the road to the correct diagnosis is often complicated in the pediatric population, as typical diagnostic tools such as fundus examination, electrodiagnostic studies, and other imaging modalities may be difficult to perform in the pediatric patient. In this review, we describe the most significant IRDs with onset during the pediatric years (ie, before the age of 18)...
March 14, 2018: Asia-Pacific Journal of Ophthalmology
Heather Lindstrom, Nigel L Ashworth
INTRODUCTION: This study aims to evaluate the usefulness of electrodiagnostic (EDX) studies in terms of the patient's diagnosis and subsequent management, and to identify patient groups where EDX is particularly useful. METHODS: The records of new patients referred to a single tertiary hospital EDX laboratory during one calendar year were reviewed to determine if EDX studies changed the diagnosis and/or management plan. Logistic regression was used to see if there were any factors that were associated with changed diagnosis or management...
March 13, 2018: Muscle & Nerve
Malo Le Hanneur, Andres A Maldonado, Benjamin M Howe, Michelle L Mauermann, Robert J Spinner
BACKGROUND: Several hypotheses have been proposed for the pathophysiology of suprascapular nerve (SSN) palsy, including compression, traction, and nerve inflammation. OBJECTIVE: To provide insight into the pathophysiology of isolated nontraumatic SSN palsy by performing critical reinterpretations of electrodiagnostic (EDX) studies and magnetic resonance (MR) images of patients with such diagnosis. METHODS: We retrospectively reviewed all patients referred to our institution for the past 20 yr with a diagnosis of nontraumatic isolated suprascapular neuropathy who had an upper extremity EDX study and a shoulder or brachial plexus MR scan...
February 26, 2018: Neurosurgery
Brigitte Tampin, Jan Vollert, Annina B Schmid
OBJECTIVE: Distal and proximal entrapment neuropathies such as carpal tunnel syndrome (CTS) and cervical radiculopathy (CR) share similar etiologies. Experimental models suggest that despite comparable etiology, pathomechanisms associated with injuries of the peripheral and central axon branches are distinct. This study therefore compared self-reported and elicited sensory profiles in patients with distal and proximal entrapment neuropathies. METHODS: Patients with electrodiagnostically confirmed CTS (nā€‰=ā€‰103) and patients with CR (nā€‰=ā€‰23) were included in this study...
March 10, 2018: Current Medical Research and Opinion
Gi-Young Park, Dong Rak Kwon, Jung Im Seok, Dong-Soon Park, Hee Kyung Cho
Background Carpal tunnel syndrome (CTS) is the most common peripheral compression neuropathy of the upper extremity. Recently, dynamic ultrasound (US) imaging has shown differences in median nerve mobility between the affected and unaffected sides in CTS. Purpose The present study was performed to compare the median nerve mobility between patients with CTS and healthy individuals, and to correlate median nerve mobility with the severity of CTS. Material and Methods A total of 101 patients (128 wrists) with CTS and 43 healthy individuals (70 wrists) were evaluated...
January 1, 2018: Acta Radiologica
Ikjae Lee, Hani Kushlaf
INTRODUCTION: The aim of this study was to evaluate needle electromyography (EMG) practice patterns among electromyographers in patients taking novel oral anticoagulants (NOACs). METHODS: A survey questionnaire was sent to members of the American Association of Neuromuscular and Electrodiagnostic Medicine (AANEM) via email weblink. Anonymous survey responses were collected through an online website. RESULTS: 58 AANEM members responded, 28 (48%) of whom worked at a teaching hospital and 30 (52%) in a private setting...
March 6, 2018: Muscle & Nerve
Dong Yoon Park, Seok Kang, Jin Seok Jeong, Joon Shik Yoon
INTRODUCTION: The purpose of this study was to investigate the usefulness of the echogenicity (EI) ratio of the thenar to hypothenar muscle measured using ultrasonography in assessing the severity of carpal tunnel syndrome (CTS). METHODS: Fifty-nine hands of 30 patients electrodiagnostically confirmed as having CTS were classified into 3 subgroups (mild, moderate, and severe). The EI of the thenar and hypothenar muscles was measured with ultrasonography, and the EI ratio was calculated in the patients and 13 normal participants (26 hands)...
March 6, 2018: Muscle & Nerve
Min K Kang, Rajesh K Gupta, Jayashri Srinivasan
We describe 2 patients presenting with multiplex mononeuritis, associated with skin manifestation, secondary to minocycline-induced vasculitis. One of the cases is associated neither with lupus nor polyarteritis nodosa. An extensive laboratory workup ruled out any possible underlying immunologic disorder. Electrodiagnostic studies were conducted to show axonal neuropathy in patchy and multifocal distribution consistent with multiplex mononeuritis. This diagnosis was confirmed with nerve biopsy. Withdrawing from the offending medication, minocycline, improved the patients' clinical condition and the quantitative serological measures...
March 2018: Journal of Clinical Neuromuscular Disease
Alexandra Filippakis, Doreen T Ho, Juan E Small, Kirstin M Small, Erik R Ensrud
Painful neurogenic hypertrophy is a rare complication of radiation therapy. We report a 27-year-old woman with a history of adenoid cystic carcinoma of the submandibular gland presented with painful twitching of her left shoulder. Electrodiagnostic studies were consistent with a diagnosis of radiation-induced spinal accessory nerve hyperactivity. The patient failed conventional medical therapy. She was treated with an injection of botulinum toxin A, and within 1 month experienced significant relief of symptoms...
March 2018: Journal of Clinical Neuromuscular Disease
Ahmad Daher, Carlos Kamiya-Matsuoka, Karin Woodman
Peripheral nervous system damage from hematologic malignancies is related to neoplastic cells infiltration of peripheral nerves or to monoclonal antibody production cross-reacting with peripheral nerves' antigens. Neurolymphomatosis (NL), a rare manifestation of hematologic malignancies, occurs when malignant cells invade the peripheral nerves leading to various manifestations. Here, we report a case of NL with 2 hematologic malignancies in a 79-year-old woman presenting with lower extremity pain/weakness. Investigation revealed anemia, IgM kappa monoclonal gammopathy, and elevated anti-MAG titer...
March 2018: Journal of Clinical Neuromuscular Disease
David K Lorance, Kelly A Mandigo, Michael K Hehir
OBJECTIVES: We report the clinical phenotype in 3 consecutive generations with demyelinating Charcot-Marie-Tooth disease that possess a novel sequence variant of myelin protein zero (MPZ). METHODS: Family members from 3 consecutive generations were interviewed, examined, and studied with electrodiagnostic testing. Commercially available next-generation sequencing was performed for the proband. Single-gene analysis was performed for the remaining family members. RESULTS: All patients demonstrated symmetric distal weakness; symmetric distal sensory loss; and diminished deep tendon reflexes...
March 2018: Journal of Clinical Neuromuscular Disease
Ahmet Yildirim, Turgut Adatepe, Aysegul Gunduz, Orhan Yagiz, Nurten Uzun
Repetitive nerve stimulation (RNS) is a highly sensitive electrophysiological test used for diagnosing myasthenia gravis (MG). Here, we evaluated electrodiagnostic value of RNS using facial nerve and occipitalis muscle. Patients with generalized MG were included. Clinical findings were assessed. RNS test was performed on occipitalis, nasalis, trapezius, abductor policis brevis (APB) and abductor digiti minimi (ADM) muscles. Twenty-five (78%) patients had relevant decrement during RNS test of at least one muscle...
February 10, 2018: Acta Neurologica Belgica
Sze En Sim, Jayaletchumi Gunasagaran, Khean-Jin Goh, Tunku Sara Ahmad
STUDY DESIGN: Prospective randomized study. INTRODUCTION: Carpal tunnel syndrome (CTS) has been described as the most common compression neuropathy. Many modalities exist for conservative treatment. Efficacy of each modality has been described in the literature. However, the effectiveness of combination of these modalities is not well established. The purpose of this study is to assess the short-term clinical outcome of conservative treatment for CTS comparing orthosis alone with combination of orthosis, nerve/tendon gliding exercises, and ultrasound therapy...
February 7, 2018: Journal of Hand Therapy: Official Journal of the American Society of Hand Therapists
Francis Renault, Roberto Flores-Guevara, Bernard Sergent, Jean Jacques Baudon, Jessie Aouizerate, Marie-Paule Vazquez, Cyril Gitiaux
INTRODUCTION: We designed a retrospective study of 59 patients with congenital sporadic non-progressive bilateral facial and abducens palsies. METHODS: Examinations included needle EMG of facial and oral muscles, facial nerve motor latency and conduction velocity (FNCV), and blink responses (BRs). RESULTS: Neurogenic EMG changes were found in one or more muscles in 55/59 patients, with no abnormal spontaneous activity. EMG changes were homogeneously neurogenic in 17 patients, homogeneously myopathic in one, and heterogeneous in 41/59 patients...
February 9, 2018: Muscle & Nerve
Francesc Miralles
Objetive. MUNIX is a technique based on surface electromyogram (sEMG) that is gaining acceptance as a method to monitoring motor neuron loss because is reliable and produces less discomfort than other electrodiagnostic techniques aimed to the same purpose. MUNIX assumes that the relationship between the area of sEMG obtained at increasing levels of muscle activation and the values of a variable called "Ideal case motor unit count" (ICMUC), defined as the product of the ratio between area and power of the M-wave by that of the sEMG, is described by a decreasing power function...
February 9, 2018: Journal of Neural Engineering
Simon Podnar
OBJECTIVE: Although ultrasonographic (US) visualization of peripheral nerves is becoming more and more frequently used, there are few studies on its actual contribution to the diagnosis and management of patients with peripheral nerve disorders. METHODS: The electronic records of consecutive patients referred to our US laboratory over an eight-month period were retrospectively analyzed. The contribution of US examination to patient management was evaluated. RESULTS: Two hundred and thirty one consecutive patients (43% men) were analyzed...
February 4, 2018: Neurophysiologie Clinique, Clinical Neurophysiology
Suraj A Muley, Stacy Holzbauer, Brent Clark, James Sejvar, Ruth Lynfield, Gareth Parry, Aaron S DeVries
IMPORTANCE: Workers exposed to aerosolized brain in a swine-processing plant developed immune-mediated polyradiculoneuropathy (IP) possibly triggered by an immune response. OBJECTIVE: Immunohistochemistry results were correlated with electrophysiological variables to examine the immunopathogenesis of this disorder. DESIGN/SETTING: Laboratory studies used normal nerve tissue that was exposed to sera from 12 IP patients; 10 exposed controls; and 10 unexposed controls...
February 15, 2018: Journal of the Neurological Sciences
Anthony G Robson, Josefin Nilsson, Shiying Li, Subhadra Jalali, Anne B Fulton, Alma Patrizia Tormene, Graham E Holder, Scott E Brodie
Clinical electrophysiological testing of the visual system incorporates a range of noninvasive tests and provides an objective indication of function relating to different locations and cell types within the visual system. This document developed by the International Society for Clinical Electrophysiology of Vision provides an introduction to standard visual electrodiagnostic procedures in widespread use including the full-field electroretinogram (ERG), the pattern electroretinogram (pattern ERG or PERG), the multifocal electroretinogram (multifocal ERG or mfERG), the electrooculogram (EOG) and the cortical-derived visual evoked potential (VEP)...
February 3, 2018: Documenta Ophthalmologica. Advances in Ophthalmology
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