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myotome weakness

Muneharu Ando, Tetsuya Tamaki, Takuji Matsumoto, Kazuhiro Maio, Masatoshi Teraguchi, Noboru Takiguchi, Hiroki Iwahashi, Makiko Onishi, Yukihiro Nakagawa, Hiroshi Iwasaki, Shunji Tsutsui, Masanari Takami, Hiroshi Yamada
Laminoplasty, frequently performed in patients with cervical myelopathy, is safe and provides relatively good results. However, motor palsy of the upper extremities, which occurs after decompression surgery for cervical myelopathy, often reduces muscle strength of the deltoid muscle, mainly in the C5 myotome. The aim of this study was to investigate prospectively whether postoperative deltoid weakness (DW) can be predicted by performing intraoperative neurophysiological monitoring (IONM) during cervical laminoplasty and to clarify whether it is possible to prevent palsy using IONM...
April 17, 2018: Journal of Clinical Monitoring and Computing
D K Boruah, A Prakash, B B Gogoi, R R Yadav, D D Dhingani, B Sarma
BACKGROUND AND PURPOSE: Hirayama disease is a benign focal amyotrophy of the distal upper limbs involving C7, C8, and T1 segmental myotomes with sparing of the brachioradialis and proximal muscles of the upper limb innervated by C5-6 myotomes. The objective of the present study was to study the utility of MR imaging in young patients presenting with weakness and wasting of the distal upper extremity and to evaluate the importance of the laminodural space during flexion cervical MR imaging...
March 15, 2018: AJNR. American Journal of Neuroradiology
Julio D Montejo, Joaquin Q Camara-Quintana, Daniel Duran, Jeannine M Rockefeller, Sierra B Conine, Alyssa M Blaise, Kristopher T Kahle, Michael L DiLuna
OBJECTIVE Lumbar disc herniation (LDH) in the pediatric population is rare and exhibits unique characteristics compared with adult LDH. There are limited data regarding the safety and efficacy of minimally invasive surgery (MIS) using tubular retractors in pediatric patients with LDH. Here, the outcomes of MIS tubular microdiscectomy for the treatment of pediatric LDH are evaluated. METHODS Twelve consecutive pediatric patients with LDH were treated with MIS tubular microdiscectomy at the authors' institution between July 2011 and October 2015...
May 2018: Journal of Neurosurgery. Pediatrics
Charmaine Baxter, Thomas A Miller, Douglas C Ross, Christopher Doherty
Cervical spondylotic amyotrophy is characterized by severe, proximal upper extremity weakness including an inability to abduct the shoulder and flex the elbow. Treatment using both medical and surgical decompression approaches has produced variable results. This paper reports the use of nerve transfers (spinal accessory to suprascapular, flexor carpi ulnaris fascicle of ulnar to biceps motor branch, radial nerve branch to triceps to axillary) to restore shoulder and elbow function in a case of unilateral cervical spondylotic amyotrophy involving C5 and C6 myotomes...
February 16, 2018: Journal of Hand Surgery
Mehmet Güney Şenol, Cengiz Kaplan, Fatih Ozdağ, Mehmet Saraçoğlu
Background and Objective: This study aims to determine the period of reinnervation in patients with poliomyelitis. This research was conducted to identify the appearance of denervation potentials in patients with poliomyelitis as indicators for reinnervation. Materials and Methods: A total of 246 male patients with poliomyelitis were assessed electrophysiologically between 1988 and 2007. The mean age was 22.8 (18-42). It has been an average of 19.9 ± 4.9 years since the beginning of complaints from the patients...
October 2017: Journal of Neurosciences in Rural Practice
Tsui-Fen Yang, Jan-Wei Chiu, Chi-Kuang Feng, Ying-Chou Hsieh, Chen-Ya Yang, Jia-Chi Wang, Kwong-Kum Liao
The precise placement of recording electrodes at the relevant myotome is mandatory while performing pedicle screw stimulation (PSS) during spine surgery; however, their placement at trunk muscles is challenging. This study aimed to determine whether ultrasound guidance is useful for trunk muscle localization for PSS during spine surgery. A retrospective clinical study was conducted from a prospective database. Eighty-four patients eligible for spine surgery were recruited. Ultrasound was used to localize the intercostal, rectus abdominis, and internal oblique and psoas muscles if pedicle screw placement was performed at T3 to L1...
June 7, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Zachary L McCormick, Ariana Nelson, Mark C Kendall, Robert J McCarthy, Geeta Nagpal, David R Walega
Objective: Low-dose local anesthetic is often used in cervical interlaminar epidural steroid injections (CIESI), yet its effect on upper extremity strength has not been studied. The presence of consequent weakness has potential implications for postprocedure safety. This study aimed to determine whether low-dose lidocaine in a C7-T1 CIESI causes objective weakness. Design: Prospective case series. Setting: Academic pain center. Subjects: Adults, cervical radicular pain...
December 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Andreia M Nunes, Ryan D Wuebbles, Apurva Sarathy, Tatiana M Fontelonga, Marianne Deries, Dean J Burkin, Sólveig Thorsteinsdóttir
Merosin-deficient congenital muscular dystrophy type 1A (MDC1A) is a dramatic neuromuscular disease in which crippling muscle weakness is evident from birth. Here, we use the dyW mouse model for human MDC1A to trace the onset of the disease during development in utero. We find that myotomal and primary myogenesis proceed normally in homozygous dyW-/- embryos. Fetal dyW-/- muscles display the same number of myofibers as wildtype (WT) muscles, but by E18.5 dyW-/- muscles are significantly smaller and muscle size is not recovered post-natally...
June 1, 2017: Human Molecular Genetics
Zhen-Zhou Li, Shu-Xun Hou, Wei-Lin Shang, Ke-Ran Song, Hong-Liang Zhao
BACKGROUND: Conventional percutaneous endoscopic lumbar discectomy (PELD) with an "inside-outside" technique has 4.3% - 10.3% surgical failure rate, especially in central herniated discs (HDs), migrated HDs, and axillary type HDs. PELD with foraminoplasty has been used for complex HDs. Percutaneous lumbar foraminoplasty (PLF), which is performed with a trephine or bone reamer introduced over a guidewire without a protective working cannula in the original Tessys technique, can quickly cut the hypertrophied bony structure under fluoroscopic guidance, and risk injury to the exiting and traversing nerve roots...
January 2017: Pain Physician
Jose D Avila, David Lacomis, Erek M Lam
Hepatitis E is an emerging viral infection in developed countries. It can present with multiple extra-hepatic manifestations, including neuralgic amyotrophy. We report a 52-year-old man who presented with neck and shoulder pain followed by orthopnea and left arm weakness. Electrodiagnostic testing showed left phrenic neuropathy and denervation in bilateral C5 and C6 myotomes. He also had elevated liver enzymes, which led to the diagnosis of acute hepatitis E. This is the first case of neuralgic amyotrophy associated with hepatitis E in the United States...
December 2016: Journal of Clinical Neuromuscular Disease
Valerio Vitale, Ferdinando Caranci, Chiara Pisciotta, Fiore Manganelli, Francesco Briganti, Lucio Santoro, Arturo Brunetti
BACKGROUND: Hirayama's disease (HD), is a benign, self-limited, motor neuron disease, characterized by asymmetric weakness and atrophy of one or both distal upper extremities. In the present study we report the clinical, electrophysiological and MRI features of a group of Italian patients, with review of the literature. Moreover we propose an optimized MRI protocol for patients with suspected or diagnosed HD in order to make an early diagnosis and a standardized follow up. METHODS: Eight patients with clinical suspicion of Hirayama disease underwent evaluation between January 2007 and November 2013...
August 2016: Quantitative Imaging in Medicine and Surgery
Jennifer Robblee, Hans Katzberg
Identifying "where is the lesion" is particularly important in the approach to the patient with focal dysfunction where a peripheral localization is suspected. This article outlines a methodical approach to the neuromuscular patient in distinguishing focal neuropathies versus radiculopathies, both of which are common presentations to the neurology clinic. This approach begins with evaluation of the sensory examination to determine whether there are irritative or negative sensory signs in a peripheral nerve or dermatomal distribution...
2016: Frontiers in Neurology
Joshua P Klein
Weakness and numbness occur in a variety of patterns that reflect injury to different parts of the central and peripheral nervous system. Progressive symptoms most often signify an underlying structural or degenerative problem. Familiarity with the major descending motor and ascending sensory tracts of the central nervous system, as well as radicular (dermatome and myotome) and peripheral nerve anatomy, is essential. Damage to these tracts and nerve fibers produces characteristic clinical symptoms and signs...
2016: Handbook of Clinical Neurology
Eman Al-Ghawi, Talal Al-Harbi, Adnan Al-Sarawi, Mohamed Binfalah
BACKGROUND: Monomelic amyotrophy is an uncommon, benign, unilateral disorder of the lower motor neurons, affecting predominantly the hand and forearm muscles. Proximal involvement of the arm and shoulder muscles is an unusual presentation that has been rarely reported in the literature. CASE PRESENTATION: A 28-year-old white man presented with insidious-onset, slowly progressive, unilateral weakness and atrophy of his left shoulder girdle and deltoid muscles. A neurological examination revealed weakness and atrophy in his left deltoid, infraspinatus and supraspinatus muscles...
March 17, 2016: Journal of Medical Case Reports
S W Bell, M J C Brown, T J Hems
PURPOSE: We reviewed patients with partial supraclavicular brachial plexus injuries in order to refine the myotome values of the upper limb. METHODS: Forty-two patients with defined partial injuries to the supraclavicular brachial plexus were reviewed from a prospective database. The injuries patterns covered C5, C5-6, C5-7, C5-8, C7-T1 and C8-T1 roots. Upper plexus injuries were classified on the basis of surgical exploration and intraoperative stimulation and lower plexus injuries from MRI...
February 2017: Surgeon: Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland
Kunihiko Araki, Hirotaka Nakanishi, Tomohiko Nakamura, Naoki Atsuta, Shinichiro Yamada, Yasuhiro Hijikata, Atsushi Hashizume, Keisuke Suzuki, Masahisa Katsuno, Gen Sobue
We describe the case of a 33-year-old man with a 4-year history of worsening muscle stiffness and weakness in his right hand. He showed elevated serum creatine kinase levels at the onset of muscle stiffness that was characterized by delayed muscle relaxation after voluntary contraction. This symptom often occurred during cold exposure, and was partially attenuated by sodium channel blockade. Electrodiagnostic findings in repetitive nerve stimulation, short-exercise, and cooling tests were normal. Electromyography showed chronic denervation potentials in his cranial, cervical, thoracic, and lumbosacral myotomes without myotonic discharge...
November 2015: Neuromuscular Disorders: NMD
Marc Gotkine, Alon Abraham, Vivian E Drory, Zohar Argov, John Moshe Gomori, Sergiu C Blumen
BACKGROUND: The syndrome of isolated progressive upper-limb distal weakness and atrophy results from disease processes affecting lower motor neurons originating in the cervical anterior horn gray matter. Lower motor neuron dysfunction restricted to the C7-T1 myotomes in the absence of neuropathy, upper motor neuron signs, sphincter disturbances or abnormality on conventional MR imaging is suggestive of either Hirayama disease (HD), or the initial manifestation of a progressive motor neuron disease such as amyotrophic lateral sclerosis (ALS)...
October 15, 2014: Journal of the Neurological Sciences
Mário Correia de Sá, Henrique Costa, Sérgio Castro, Marta Vila Real
Hirayama disease, also known as monomelic amyotrophy or juvenile spinal muscular atrophy of the distal upper extremity features the impairment of the anterior horn cells of the distal cervical spinal cord secondary to dural sac anterior displacement during cervical flexion. We describe a case of a 17-year-old boy with a history of scoliosis, evaluated in the emergency department for decreased muscle strength and atrophy of the left upper limb with progressive worsening for about 6 months. We performed electrophysiological studies that showed severe neurogenic atrophy involving the C7-T1 left myotomes...
2013: BMJ Case Reports
M Mondelli, A Aretini, U Arrigucci, F Ginanneschi, G Greco, F Sicurelli
STUDY AIM: This prospective study aim to examine whether clinical findings and electrodiagnostic testing (EDX) in patients with lumbosacral monoradiculopathy due to herniated disc (HD) differ as a function of root involvement level (L5 vs. S1) and HD zone (paramedian vs. intraforaminal). PATIENTS AND METHODS: All patients with L4, L5 or S1 monoradiculopathy were prospectively enrolled at four electromyography (EMG) labs over a 2-year period. The diagnosis was based on a congruence between patient history and MRI evidence of HD...
October 2013: Neurophysiologie Clinique, Clinical Neurophysiology
A Abraham, M Gotkine, V E Drory, S C Blumen
UNLABELLED: Hirayama disease (HD) is a rare motor disorder mainly affecting young men, characterized by atrophy and weakness of forearm and hand muscles corresponding to a C7-T1 myotome distribution. The weakness is usually unilateral or asymmetric and progression usually stops within several years. The etiology of HD is not well understood. One hypothesis, mainly based on MRI findings, is that the weakness is a consequence of cervical flexion myelopathy. The aim of this study was to explore the function of corticospinal and ascending somatosensory pathways during neck flexion using evoked responses...
November 15, 2013: Journal of the Neurological Sciences
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