共查询到9条相似文献,搜索用时 0 毫秒
1.
OBJECTIVES: To evaluate the use of fixed distance side to side comparison of abductor digiti minimi (ADM) and first dorsal interosseous (FDI) compound muscle action potential (CMAP) studies in the diagnosis of distal ulnar neuropathy. MATERIALS AND METHODS: Thirty normal controls underwent ADM and FDI CMAP studies bilaterally at a fixed ADM recording to stimulating point distance of 6 cm. Side to side mean latency differences to both muscles were calculated. Twenty patients with suspected unilateral distal ulnar neuropathy from routine nerve conduction studies had positive results when compared with controls. RESULTS: The upper limit of normal for side to side mean latency difference at 3 SD above the mean was 0.394 and 0.474 ms for ADM and FDI, respectively. All 20 patients had side to side mean CMAP latency difference above 3 SDs in the ADM, FDI or both muscles. Fifty percent of cases had involvement of the superficial sensory branch. CONCLUSIONS: Fixed distance side to side CMAP latency comparison is a useful electrodiagnostic adjunct for distal ulnar neuropathy. Trauma was the most common aetiology in the 20 reported cases. Correlation was found between aetiological factors and sites of lesions as localized with this method. 相似文献
2.
Antonios Kerasnoudis Kalliopi Pitarokoili Volker Behrendt Ralf Gold Min‐Suk Yoon 《Journal of the peripheral nervous system : JPNS》2014,19(2):165-174
We present nerve ultrasound findings in multifocal motor neuropathy (MMN) and examine their correlation with electrophysiology and functional disability. Eighty healthy controls and 12 MMN patients underwent clinical, sonographic, and electrophysiological evaluation a mean of 3.5 years (standard deviation [SD] ± 2.1) after disease onset. Nerve ultrasound revealed significantly higher cross‐sectional area (CSA) values of the median (forearm, p < 0.001), ulnar (p < 0.001), and tibial nerve (ankle, p < 0.001) when compared with controls. Electroneurography documented signs of significantly lower values of the motor conduction velocity and compound muscle action potentials (cMAPs) in the upper arm nerves (median, ulnar, radial, p < 0.001). A significant correlation between sonographic and electrophysiological findings in the MMN group was found only between cMAP and CSA of the median nerve at the upper arm (r = 0.851, p < 0.001). Neither nerve sonography nor electrophysiology correlated with functional disability. MMN seems to show inhomogeneous CSA enlargement in various peripheral nerves, with weak correlation to electrophysiological findings. Neither nerve sonography nor electrophysiology correlated with functional disability. Multicentre, prospective studies are required to prove the applicability and diagnostic values of these findings. 相似文献
3.
Ioannis Karakis Wendy Liew Heather Szelag Fournier H. Royden Jones Basil T. Darras Peter B. Kang 《Clinical neurophysiology》2017,128(5):751-755
Objective
To analyze patterns of nerve injury in pediatric ulnar neuropathy (PUN).Methods
Retrospective analysis of 49 children with PUN.Results
Sensory loss in digit V was the prevailing complaint (89%). Predominant localization was at the elbow (55%). Diminished ulnar SNAP was the most common abnormality (71%) with median axon loss estimate (MAXE) of 62%. Dorsal ulnar cutaneous (DUC) sensory nerve action potential (SNAP) was reduced in 55% with MAXE of 43%. Abductor digiti minimi (ADM) and first dorsal interosseous (FDI) compound muscle action potential (CMAP) were reduced half of the time, with MAXE of 30% and 28% respectively. There was high correlation between ulnar sensory MAXE and ADM MAXE (r = 0.76, p < 0.0001), FDI MAXE (r = 0.81, p < 0.0001) and DUC MAXE (r = 0.60, p = 0.0048). Neurogenic changes were seen in the ADM, FDI, flexor carpi ulnaris (FCU) and flexor digitorum profundus IV (FDP IV) in 79%, 77%, 25% and 35% respectively. Pathophysiology was demyelinating in 27%, axonal in 59% and mixed in 14%.Conclusions
In proximal axonal lesions, sensory fibers to digit V and motor fibers to distal muscles are predominantly affected, whereas in demyelinating lesions, slowing occurs twice as frequently as conduction block.Significance
There is frequent axonal and fascicular injury in PUN. 相似文献4.
Jun-Soon Kim Myoung-jin Jang Seung-Jae Hyun Ki-Jeong Kim Tae-Ahn Jahng Hyun-Jib Kim Sung-Min Kim Kyung Seok Park 《Clinical neurophysiology》2018,129(11):2276-2283
Objective
To identify factors associated with the failure to generate baseline muscle motor evoked potentials (mMEPs) during spinal surgery, and to determine the association between baseline mMEP generation and postoperative outcomes.Methods
A total of 345 patients who underwent spine surgery with intraoperative mMEP monitoring were included, and we retrospectively reviewed their demographic/clinical parameters, and mMEP recording results according to lesion locations.Results
Multivariable logistic regression analysis revealed that preoperative Medical Research Council grade of the weakest muscle <3 was significantly associated with failure of baseline mMEP generation in both cervical and thoracic lesions. In addition, high intramedullary T2 signal intensity on spine MRI for cervical lesions and male sex for thoracic lesions were also significantly associated with baseline mMEP generation failure. Moreover, the failure of baseline mMEP generation was a significantly associated factor for poor functional outcome in patients with thoracic lesions.Conclusion
Sex, radiological abnormality, and preoperative functional status were associated with baseline mMEP generation failure during spine surgery with different patterns according to lesion location. Moreover, baseline mMEP generation failure in thoracic lesion could be associated with risk of postoperative deficits.Significance
The risk of baseline mMEP recording failure could be evaluated based on preoperative clinical parameters. 相似文献5.
Baumann F Henderson RD Gareth Ridall P Pettitt AN McCombe PA 《Clinical neurophysiology》2012,123(10):2092-2098
Objective
To use our Bayesian method of motor unit number estimation (MUNE) to evaluate lower motor neuron degeneration in ALS.Methods
In subjects with ALS we performed serial MUNE studies. We examined the repeatability of the test and then determined whether the loss of MUs was fitted by an exponential or Weibull distribution.Results
The decline in motor unit (MU) numbers was well-fitted by an exponential decay curve. We calculated the half life of MUs in the abductor digiti minimi (ADM), abductor pollicis brevis (APB) and/or extensor digitorum brevis (EDB) muscles. The mean half life of the MUs of ADM muscle was greater than those of the APB or EDB muscles. The half-life of MUs was less in the ADM muscle of subjects with upper limb than in those with lower limb onset.Conclusions
The rate of loss of lower motor neurons in ALS is exponential, the motor units of the APB decay more quickly than those of the ADM muscle and the rate of loss of motor units is greater at the site of onset of disease.Significance
This shows that the Bayesian MUNE method is useful in following the course and exploring the clinical features of ALS. 相似文献6.
Zhao Li Dong Tian Lingfen Chen Xiaoqing Wang Lijuan Jiang Yude Yu 《Clinical neurophysiology》2017,128(2):384-390
Objective
To evaluate the potential of electrical impedance myography (EIM), which is sensitive to the changes in muscle structure and physiology, in discriminating traumatic peripheral nerve injury (TPNI) in the upper extremity. To identify factors that primarily influence muscle atrophy secondary to nerve injury.Methods
Thirty-nine patients with TPNI underwent EIM measurement and standard electromyography tests for multiple muscles in the upper extremity. The side-to-side differences in EIM parameters were calculated for each subject and compared with the compound motor action potential (CMAP) amplitude, which is a measure of injury severity, and the time since injury.Results
The reactance and phase values of the affected muscles were consistently lower than those of healthy muscles, with an average side-to-side difference of approximately ?50% (p < 0.001) and ?45% (p < 0.001), respectively. The CMAP amplitude, rather than the time since injury, had a greater effect on the side-to-side difference of phase values.Conclusions
EIM discriminates TPNI by revealing asymmetries in reactance and phase values. The severity of injury had a larger influence than the time since injury on muscle atrophy secondary to nerve injury.Significance
These results demonstrate the putative use of EIM in discriminating TPNI and deserves further study. 相似文献7.
Christoph Neuwirth Paul E. Barkhaus Christian Burkhardt José Castro David Czell Mamede de Carvalho Sanjeev Nandedkar Erik Stålberg Markus Weber 《Clinical neurophysiology》2017,128(3):495-500
Objective
Motor Unit Number Index (MUNIX) is a quantitative neurophysiological measure that provides an index of the number of lower motor neurons supplying a muscle. It reflects the loss of motor neurons in patients with Amyotrophic Lateral Sclerosis (ALS). However, it is unclear whether MUNIX also detects motor unit loss in strong, non-wasted muscles.Methods
Three centres measured MUNIX in 49 ALS patients every three months in six different muscles (abductor pollicis brevis, abductor digiti minimi, biceps brachii, tibialis anterior, extensor digitorum brevis, abductor hallucis) on the less affected side. The decline of MUNIX in initially non-wasted, clinically strong muscles (manual muscle testing, MMT grade 5) was analysed before and after onset of weakness.Results
In 49 subjects, 151 clinically strong muscles developed weakness and were included for analysis. The average monthly relative loss of MUNIX was 5.0% before and 5.6% after onset of weakness. This rate of change was significantly higher compared to ALS functional rating scale (ALSFRS-R) and compound muscle action potential (CMAP) change over 12 months prior to the onset of muscle weakness (p = 0.024).Conclusion
MUNIX is an electrophysiological marker that detects lower motor neuron loss in ALS, before clinical weakness becomes apparent by manual muscle testing.Significance
This makes MUNIX a good biomarker candidate for disease progression and possibly pharmacodynamics responds. 相似文献8.
Claudia V. Turco Jenin El-Sayes Mitchell J. Savoie Hunter J. Fassett Mitchell B. Locke Aimee J. Nelson 《Brain stimulation》2018,11(1):59-74
Transcranial magnetic stimulation (TMS) is an ideal technique for non-invasively stimulating the brain and assessing intracortical processes. By delivering electrical stimuli to a peripheral nerve prior to a TMS pulse directed to the motor cortex, the excitability and integrity of the sensorimotor system can be probed at short and long time intervals (short latency afferent inhibition, long latency afferent inhibition). The goal of this review is to detail the experimental factors that influence the magnitude and timing of afferent inhibition in the upper limb and these include the intensity of nerve and TMS delivery, and the nerve composition. Second, the neural mechanisms of SAI are discussed highlighting the lack of existing knowledge pertaining to LAI. Third, the usage of SAI and LAI as a tool to probe cognition and sensorimotor function is explored with suggestions for future avenues of research. 相似文献
9.
《Clinical neurophysiology》2019,130(2):315-319
ObjectiveThere is still insufficient knowledge about natural history in adult spinal muscular atrophy, thus valid markers for treatment and disease monitoring are urgently needed.MethodsWe studied hand muscle innervation pattern of 38 adult genetically confirmed 5q spinal muscular atrophy (SMA) patients by the motor unit number index (MUNIX) method. Data were compared to healthy controls and amyotrophic lateral sclerosis (ALS) patients and systematically correlated to typical disease-relevant scores and other clinical as well as demographic characteristics.ResultsDenervation of hand muscles in adult SMA was not evenly distributed. By calculation of the MUNIX ratios, we identified a specific hand muscle wasting pattern for SMA which is different to the split hand in ALS. Furthermore, MUNIX parameters strongly correlated with established disease course parameters independent of disease stages.ConclusionWe found a pathophysiological remarkable denervation pattern of hand muscles, a ‘reversed split hand’. MUNIX of single hand muscles correlated well with disease severity and thus represents an easily available biomarker for adult SMA.SignificanceOur data show the power of the MUNIX method as a biomarker for upcoming questions in adult SMA. 相似文献