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1.
Sang-Ku Park Byung-Euk Joo Seunghoon Lee Jeong-A. Lee Jeong-Ho Hwang Doo-Sik Kong Dae-Won Seo Kwan Park Hoon-Taek Lee 《Clinical neurophysiology》2018,129(5):1097-1102
Objective
The aim of this study was to define the critical warning sign of real-time brainstem auditory evoked potential (BAEP) for predicting hearing loss (HL) after microvascular decompression (MVD) for hemifacial spasm (HFS).Methods
Nine hundred and thirty-two patients with HFS who underwent MVD with intraoperative monitoring (IOM) of BAEP were analyzed. We used a 43.9?Hz/s stimulation rate and 400 averaging trials to obtain BAEP. To evaluate HL, pure-tone audiometry and speech discrimination scoring were performed before and one week after surgery. We analyzed the incidence for postoperative HL according to BAEP changes and calculated the diagnostic accuracy of significant warning criteria.Results
Only 11 (1.2%) patients experienced postoperative HL. The group showing permanent loss of wave V showed the largest percentage of postoperative HL (p?<?0.001). No patient who experienced only latency prolongation (≥1?ms) had postoperative HL. Loss of wave V and latency prolongation (≥1?ms) with amplitude decrement (≥50%) were highly associated with postoperative HL.Conclusions
Loss of wave V and latency prolongation of 1?ms with amplitude decrement ≥50% were the critical warning signs of BAEP for predicting postoperative HL.Significance
These findings elucidate the critical warning sign of real-time BAEP. 相似文献2.
目的 探讨异常肌反应(abnormal muscle response,AMR)监测在面神经显微血管减压术(microvascular decolnpression,MVD)中鉴别责任血管、评估减压效果以及判断预后方面的作用.方法 241例典型面肌痉挛患者接受了面神经MVD术中AMR的实时监测,并在术后1周进行疗效评估,分析术中AMR变化与手术预后之问的关系.结果 所有241例患者均在术中记录到典型AMR波形,术后第1周217例(90.0%)患者症状完全缓解.AMR消失组175例,其中165例(94.3%)症状缓解;AMR未消失组66例,52例(78 8%)症状缓解.统计学分析显示AMR消失组的疗效明显好于AMR未消失组(P<0.05).结论 术中AMR监测可辅助判断责任血管,评估减压效果,对提高手术疗效具有较高的应用价值.Abstract： Objective Abnormal muscle response( AMR) to the electrical stimulation of a branch of facial nerve is a specific electrophysiological feature of primary hemifacial spasm ( HFS) .Although the correlation between intraoperative AMR findings and postoperative results in patients with HFS has been investigated before, the AMR monitoring has not been employed widely during the microvascular decompression (MVD) surgery.The aim of this study was to evaluate the value of AMR monitoring during MVD, and the correlation between the AMR changes and the clinical outcome.Method This study included 241 cases of MVD.Intraoperative AMR monitoring was performed for each subject.The patients were divided into two groups based on whether the AMR wave disappeared or not following decompression of the facial nerve.Results The AMR disappeared after MVD in 175 patients.Among these 175 patients, 165(94.3% ) patients were relieved from HFS 1 week after HFS.Out of the 66 patients in whom the AMR persisted after MVD, 52(78.8%) patients were relieved.The correlation between intraoperative AMR abolition and HFS relief was statistically significant ( P < 0.05 ) .Conclusions Intraoperative AMR monitoring is an effective assistant for a successful MVD for the patient with HFS.It may be helpful in predicting outcomes in short term and identifying offending vessels,so it should be monitored routinely during MVD. 相似文献
3.
目的 探讨神经电生理监测在原发性面肌痉挛微血管减压(MVD)术中的应用价值.方法 回顾性分析行显微血管减压手术治疗的241例原发性面肌痉挛患者的临床资料.患者术中均行神经电生理监测,包括异常肌反应(AMR)、脑干听觉诱发电位(BAEP)和面神经自由描记肌电图(Free-EMG).对神经电生理监测结果 与手术疗效及术后并... 相似文献
4.
面肌痉挛显微血管减压术中异常肌反应监测价值研究 总被引：4，自引：1，他引：3
目的探讨异常肌反应(AMR)监测在鉴别责任血管、评估减压效果以及判断预后方面的作用。方法24例面肌痉挛患者接受了术中AMR监测的研究,麻醉诱导后不使用肌松剂。采取刺激面神经颧支,记录同侧颏肌电反应的方法,分析AMR监测结果与术后疗效的关系。结果术中所有患者均记录到特征性的AMR波形。面神经根减压后AMR消失20例,AMR未消失4例。AMR消失的20例患者术后1周17例患者面肌痉挛消失,随访结果20例患者面肌痉挛消失。术中AMR未消失的4例患者术后1周1例患者面肌痉挛消失,随访结果2例患者面肌痉挛消失。经统计学分析AMR消失组的疗效明显好于AMR未消失组。结论术中AMR监测有助于鉴别责任血管,评估即刻减压效果,有助于判断手术的预后,能够显著提高面肌痉挛患者手术的长期效果。 相似文献
5.
Tadashi Hamasaki Motohiro Morioka Koichi Fujiwara Chikao Nakayama Miho Harada Kiyohiko Sakata Yu Hasegawa Toshitaka Yamakawa Kazumichi Yamada Akitake Mukasa 《Clinical neurophysiology》2018,129(10):2205-2214
Objective
Hemifacial spasm (HFS) is caused by arterial conflict at the root exit zone of the facial nerve. As the offending artery is pulsatile in nature, this study investigated the association of heart rate fluctuation with HFS.Methods
Twenty-four preoperative patients underwent simultaneous recordings of facial electromyogram and electrocardiogram overnight. Series of R-wave to R-wave intervals (RRIs) in the electrocardiogram were analyzed across subjects in relation to HFS. The degree of heart rate fluctuation was quantified by analyzing the heart rate variability (HRV). The sleep stage was evaluated during the period of HFS.Results
A 0.1?Hz fluctuation in RRIs by 5% compared to the baseline preceded a few seconds the onset of the HFS, indicating that a significant increase in the heart rate coincided with HFS. HRV analysis demonstrated that fluctuations in the heart rate were significantly enhanced during HFS. Wake or light sleep stages were more often accompanied by HFS, suggesting an association with autonomic activities.Conclusion
Our findings suggest that the etiology of HFS is more than just a mechanical compression of the facial nerve and may involve changes in pulsatile frequency in offending arteries.Significance
We propose the etiology of HFS from a unique standpoint. 相似文献6.
Alfredo Traba Juan Pablo Romero Beatriz Arranz Concepción Vilela 《Clinical neurophysiology》2018,129(10):2075-2082
Objective
Our objective is to use the area of the motor evoked potential (MEP) as a diagnostic tool for intraoperative radicular injury.Methods
We analyzed the intraoperative neurophysiological monitoring data and clinical outcomes of 203 patients treated for dorsolumbar spine deformity. The decrease in amplitude was compared with the reduction in the MEP area.Results
In 11 cases, new intraoperative injuries occurred, nine of them were lumbar radiculopathies. Our new criteria, a decrease MEP area of 70%, yielded a sensitivity and specificity of 1, since it detected all the radicular injuries, with no false positive cases. Using a 70% amplitude decrease criteria, we obtained a sensitivity of 0,89 and a specificity of 0,99. A lower threshold (65% amplitude reduction) yielded a higher number of false positives, whereas a higher threshold (75 and 80%) gave rise to a higher number of false negatives.Conclusions
The measurement of the MEP area gave evidence to be more reliable and accurate than the measurement of the amplitude reduction in order to assess and detect intraoperative radicular injuries.Significance
The criterion of decrease of the MEP area has a higher reliability and accuracy in the detection of intraoperative radicular lesions than the amplitude reduction. 相似文献7.
Min-Cheol Kang Yu-Seok Choi Hak-Ki Choi Sang-Hoon Lee Chang-Gu Ghang Chang-Hyun Kim 《Journal of Korean Neurosurgical Society》2012,52(4):372-376
Objective
The purpose of this large prospective study is to assess the association between the disappearance of the lateral spread response (LSR) before and after microvascular decompression (MVD) and clinical long term results over two years following hemifacial spasm (HFS) treatment.Methods
Continuous intra-operative monitoring during MVD was performed in 244 consecutive patients with HFS. Patients with persistent LSR after decompression (n=22, 9.0%), without LSR from the start of the surgery (n=4, 1.7%), and with re-operation (n=15, 6.1%) and follow-up loss (n=4, 1.7%) were excluded. For the statistical analysis, patients were categorized into two groups according to the disappearance of their LSR before or after MVD.Results
Intra-operatively, the LSR was checked during facial electromyogram monitoring in 199 (81.5%) of the 244 patients. The mean follow-up duration was 40.9±6.9 months (range 25-51 months) in all the patients. Among them, the LSR disappeared after the decompression (Group A) in 128 (64.3%) patients; but in the remaining 71 (35.6%) patients, the LSR disappeared before the decompression (Group B). In the post-operative follow-up visits over more than one year, there were significant differences between the clinical outcomes of the two groups (p<0.05).Conclusion
It was observed that the long-term clinical outcomes of the intra-operative LSR disappearance before and after MVD were correlated. Thus, this factor may be considered a prognostic factor of HFS after MVD. 相似文献8.
The use and yield of continuous EEG in critically ill patients: A comparative study of three centers
Vincent Alvarez Andres A. Rodriguez Ruiz Suzette LaRoche Lawrence J. Hirsch Christopher Parres Paula E. Voinescu Andres Fernandez Ognen A. Petroff Nishi Rampal Hiba Arif Haider Jong Woo Lee 《Clinical neurophysiology》2017,128(4):570-578
Objective
Continuous EEG (cEEG) monitoring of critically ill patients has gained widespread use, but there is substantial reported variability in its use. We analyzed cEEG and antiseizure drug (ASD) usage at three high volume centers.Methods
We utilized a multicenter cEEG database used daily as a clinical reporting tool in three tertiary care sites (Emory Hospital, Brigham and Women’s Hospital and Yale – New Haven Hospital). We compared the cEEG usage patterns, seizure frequency, detection of rhythmic/periodic patterns (RPP), and ASD use between the sites.Results
5792 cEEG sessions were analyzed. Indication for cEEG monitoring and recording duration were similar between the sites. Seizures detection rate was nearly identical between the three sites, ranging between 12.3% and 13.6%. Median time to first seizure and detection rate of RPPs were similar. There were significant differences in doses of levetiracetam, valproic acid, and lacosamide used between the three sites.Conclusions
There was remarkable uniformity in seizure detection rates within three high volume centers. In contrast, dose of ASD used frequently differed between the three sites.Significance
These large volume data are in line with recent guidelines regarding cEEG use. Difference in ASD use suggests discrepancies in how cEEG results influence patient management. 相似文献9.
Catherine F. Sinclair Maria J. Téllez Oscar R. Tapia Sedat Ulkatan Vedran Deletis 《Clinical neurophysiology》2017,128(7):1399-1405
Objective
To describe a novel methodology for intraoperative neuro-monitoring of laryngeal and vagus nerves by utilizing the laryngeal adductor reflex (LAR).Methods
Case series of 15 patients undergoing thyroid and cervical spine surgeries under total intravenous general anesthesia. Vocal fold mucosa was electrically stimulated to elicit a LAR using endotracheal tube based electrodes. Contralateral R1 (cR1) and R2 (cR2) responses were recorded using the endotracheal tube electrode contralateral to the simulating electrode.Results
The LAR was reliably elicited in 100% of patients for the duration of each surgical procedure. Mean onset latency of cR1 response was 22.4 ± 2.5 ms (right) and 22.2 ± 2.4 ms (left). cR2 responses were noted in 10 patients (66.7%). No peri-operative complications or adverse outcomes were observed.Conclusions
The LAR is a novel neuro-monitoring technique for the vagus nerve. Advantages over current monitoring techniques including simplicity, ability to continuously monitor neural function without placement of additional neural probes and ability to assess integrity of both sensory and motor pathways.Significance
The LAR represents a novel method for intraoperatively monitoring laryngeal and vagus nerves. The LAR monitors the entire vagus nerve reflex arc and is thus applicable to all surgeries where vagal nerve integrity may be compromised. 相似文献10.
Nora Franziska Dengler Gregor Antoniadis Christian Heinen Brigitta Grolik Christian Rainer Wirtz Ralph König Maria Teresa Pedro 《Clinical neurophysiology》2017,128(12):2384-2391
Objective
We designed this study using super-selective intraoperative cervical nerve root stimulation aiming to support decision making about complete or partial contralateral C7 (cC7) nerve root transfer in patients with multiple cervical root avulsion injury.Methods
Super-selective intraoperative stimulations of anterior, lateral, medial and posterior aspect of C5–C8 nerve roots were performed. Compound muscle action potentials (CMAP) were recorded in the lateral part of the deltoid (DM), long head of biceps brachii (BCM), brachioradial (BRM), long head of triceps brachii (TCM), and extensor digitorum communis (EDC) muscle. Muscle strength was documented immediately after cC7 transfer procedures and on scheduled follow-up visits according to the Medical Research Council (MRC) scale.Results
In the DM, stimulation of the posterior aspect of C5 resulted in the largest CMAP amplitudes (2.0?mV?±?1.9; 80%?±?28.3). The BCM CMAPs induced by the different aspects of C6 all revealed homogenous stimulation results. Stimulation of the lateral aspect of C7 induced the largest amplitude of TCM CMAPs (1.3?mV?±?1.0; 67.1%?±?43.3). CMAP amplitudes of individual muscles and individual contributions of cervical nerve roots to the TCM varied between subjects. Overall donor side morbidity was low, no permanent motor deficit occurred.Conclusion
A super-selective intraoperative cervical nerve root stimulation may help minimize donor side morbidity in transfer procedures. Individual differences of cervical nerve root innervation pattern need to be addressed in future electrophysiological studies.Significance
Our study outlines individual differences of cervical nerve root innervation pattern. 相似文献11.
Daisuke Koshiyama Kenji Kirihara Mariko Tada Tatsuya Nagai Mao Fujioka Eriko Ichikawa Kazusa Ohta Motoko Tani Maiko Tsuchiya Akiko Kanehara Kentaro Morita Kingo Sawada Jun Matsuoka Yoshihiro Satomura Shinsuke Koike Motomu Suga Tsuyoshi Araki Kiyoto Kasai 《Clinical neurophysiology》2018,129(11):2268-2275
Objectives
The gamma-band auditory steady-state response (ASSR) is thought to reflect the function of parvalbumin-positive γ-aminobutyric acid (GABA)-ergic interneurons and may be a candidate biomarker in early psychosis. Although previous cross-sectional studies have shown that gamma-band ASSR is reduced in early psychosis, whether reduced gamma-band ASSR could be a predictor of the long-term prognosis remains unknown.Methods
In this longitudinal study, we investigated the association between gamma-band ASSR reduction and future global symptomatic or functional outcome in early psychosis. We measured 40-Hz ASSR in 34 patients with recent-onset schizophrenia (ROSZ), 28 ultra-high risk (UHR) individuals, and 30 healthy controls (HCs) at baseline. After 1–2?years, we evaluated the global assessment of functioning (GAF) in the ROSZ (N?=?20) and UHR (N?=?20) groups.Results
The 40-Hz ASSR was significantly reduced in the ROSZ and UHR groups. The attenuated 40-Hz ASSR was correlated with the future global symptomatic outcome in the ROSZ, but not in the UHR groups.Conclusions
A reduction in the gamma-band ASSR after the onset of psychosis may predict symptomatic outcomes in early psychosis.Significance
Gamma-band ASSR may be a potentially useful biomarker of the long-term prognosis in patients with recent-onset schizophrenia. 相似文献12.
Thomas Schüller Theo O.J. Gruendler René Huster Juan Carlos Baldermann Daniel Huys Markus Ullsperger Jens Kuhn 《Clinical neurophysiology》2018,129(9):1866-1872
Objective
Whether motor inhibition capabilities are impaired in Tourette’s syndrome (TS) remains inconclusive. The ability to suppress tics has been proposed to ensure normal motor control in uncomplicated, adult patients. The aim of the present study was to characterize cortical processes of motor inhibition and performance monitoring using event-related potentials (ERPs) elicited by a visual stop signal task.Methods
15 TS patients and 15 matched healthy controls performed a stop signal task while multi-channel EEG were recorded.Results
The behavioral results revealed no significant differences in inhibitory capabilities between groups. The latency of the P3 was discriminative of inhibition success, with shorter latencies for successful inhibition in both groups. P3 amplitude was not altered by inhibition success, but significantly attenuated for TS patients. Furthermore, the amplitude of the error-related negativity (ERN) was elevated while the error positivity (PE) was diminished for TS patients.Conclusion
In the stop signal task performance is not altered in adult TS patients but ERPs related to motor inhibition and performance monitoring are altered suggesting potential compensatory mechanisms.Significance
The results support the hypothesis of compensatory cortical mechanisms to ensure sufficient motor performance. 相似文献13.
Brian Nils Lundstrom Christian Meisel Jamie Van Gompel Matt Stead Greg Worrell 《Clinical neurophysiology》2018,129(5):909-919
Objectives
To develop quantitative measures for estimating seizure probability, we examine intracranial EEG data from patient groups with three qualitative seizure probabilities: patients with drug resistant focal epilepsy (high), these patients during cortical stimulation (intermediate), and patients who have no history of seizures (low).Methods
Patients with focal epilepsy were implanted with subdural electrodes during presurgical evaluation. Patients without seizures were implanted during treatment with motor cortex stimulation for atypical facial pain.Results
The rate and amplitude of spikes correlate with qualitative seizure probability across patient groups and with proximity to the seizure onset zone in focal epilepsy patients. Spikes occur earlier during the negative oscillation of underlying slow activity (0.5–2?Hz) when seizure probability is increased. Similarly, coupling between slow and fast activity is increased.Conclusions
There is likely a continuum of sharply contoured activity between non-epileptiform and epileptiform. Characteristics of spiking and how spikes relate to slow activity can be combined to predict seizure onset zones.Significance
Intracranial EEG data from patients without seizures represent a unique comparison group and highlight changes seen in spiking and slow wave activity with increased seizure probability. Slow wave activity and related physiology are an important potential biomarker for estimating seizure probability. 相似文献14.
Luciana Pelosi Dominic Ming Yin Tse Eoin Mulroy Andrew M. Chancellor Michael R. Boland 《Clinical neurophysiology》2018,129(10):2155-2161
Objective
To systematically study demographic, clinical, electrophysiological and nerve ultrasound characteristics of ulnar neuropathy with abnormal non-localizing electrophysiology (NL-UN) and further define the utility of ultrasound over and above the conventional electro-diagnostic approach.Method
NL-UNs were prospectively identified from 113 consecutive referrals with suspected ulnar neuropathy. All received electro-diagnostic tests and ulnar nerve ultrasound. NL-UN severity was graded using clinical and electrophysiological scales.Results
In 64 of 113 referrals, an ulnar mono- neuropathy was confirmed by electrophysiology. Sixteen of these 64 (25%) had NL-UN, predominantly males (14 out of 16 patients) with severe or moderate clinical and electrophysiological ratings. Ultrasound showed focal ulnar neuropathy at the elbow in 13 out of 16, and diffuse ulnar nerve abnormality in three, and identified a likely or possible causative mechanism in 11.Conclusion
A significant proportion (a quarter) of ulnar neuropathies with abnormal electrophysiology were NL-UN, of heterogeneous etiology; the majority were males with significant disability and axonal loss. Ultrasound had a significant role in localization and classification that facilitated management.Significance
To our knowledge, this is the first systematic prospective study that analyzes the demographic, clinical, electrophysiological and ultrasound characteristics of NL-UN in a routine clinical neurophysiology setting. 相似文献15.
Seungwoo Cha Kyu-Chang Wang Kwanjin Park Hyung-Ik Shin Ji Yeoun Lee Sangjoon Chong Keewon Kim 《Clinical neurophysiology》2018,129(12):2594-2601
Objective
To evaluate the clinical significance of intraoperative bulbocavernosus reflex (BCR) during untethering surgery in predicting post-operative voiding function.Methods
We conducted a retrospective review of pediatric patients who underwent untethering surgery with available intraoperative baseline BCR. BCR response during surgery was classified into loss or maintenance. Post-operative voiding function was determined as worsened or maintained based on history, postvoid residual urine measurement, and urodynamic study (UDS). Data regarding demographics, diagnosis, pre-operative voiding difficulty, re-untethering, syrinx, and abnormalities in electromyography were collected for analysis.Results
We included 106 patients, with a mean age of 3.3?years, and 49 patients were male. BCR was lost in 15 patients during surgery and voiding function worsened in 14 patients after surgery. Lumbosacral lipoma was the most common diagnosis, and 16 patients were diagnosed with lipomyelomeningocele (LMMC). The sensitivity and specificity of intraoperative BCR for post-operative worsening of voiding function were 35.7%, and 88.5% at 6?months, respectively. The diagnosis of LMMC was statistically significant in a logistic regression analysis. The specificity of BCR at 6?months in patients with diagnosis other than LMMC was 93.4%, and intraoperative BCR was significant in a logistic regression analysis.Conclusions
Intraoperative BCR during untethering could predict bladder function 6?months post-operatively with high specificity (88.5%), particularly in cases other than LMMC (93.4%), indicating that voiding function deterioration will not occur if intraoperative BCR is preserved.Significance
Intraoperative BCR during untethering surgery is a useful tool to predict post-operative voiding outcome. 相似文献16.
Sarah Schnitzler Christian Johannes Hartmann Stefan Jun Groiss Lars Wojtecki Alfons Schnitzler Jan Vesper Jan Hirschmann 《Clinical neurophysiology》2018,129(5):959-966
Objective
To assess whether high frequency oscillations (HFOs, >150?Hz), known to occur in basal ganglia nuclei, can be observed in the thalamus.Methods
We recorded intraoperative local field potentials from the ventral intermediate nucleus (VIM) of the thalamus in patients with Essential Tremor (N?=?16), Parkinsonian Tremor (3), Holmes Tremor (2) and Dystonic Tremor (1) during implantation of electrodes for deep brain stimulation. Recordings were performed with up to five micro/macro-electrodes that were simultaneously advanced to the stereotactic target.Results
Thalamic HFOs occurred in all investigated tremor syndromes. A detailed analysis of the Essential Tremor subgroup revealed that medial channels recorded HFOs more frequently than other channels. The highest peaks were observed 4?mm above target. Macro- but not microelectrode recordings were dominated by peaks in the slow HFO band (150–300?Hz), which were stable across several depths and channels.Conclusion
HFOs occur in the thalamus and are not specific to any of the tremors investigated. Their spatial distribution is not homogeneous, and their appearance depends on the type of electrode used for recording.Significance
The occurrence of HFOs in the thalamus of tremor patients indicates that HFOs are not part of basal ganglia pathophysiology. 相似文献17.
Amir G. Baroumand Pieter van Mierlo Gregor Strobbe Lars H. Pinborg Martin Fabricius Guido Rubboli Anne-Mette Leffers Peter Uldall Bo Jespersen Jannick Brennum Otto Mølby Henriksen Sándor Beniczky 《Clinical neurophysiology》2018,129(11):2403-2410
Objective
To evaluate the accuracy of automated EEG source imaging (ESI) in localizing epileptogenic zone.Methods
Long-term EEG, recorded with the standard 25-electrode array of the IFCN, from 41 consecutive patients with focal epilepsy who underwent resective surgery, were analyzed blinded to the surgical outcome. The automated analysis comprised spike-detection, clustering and source imaging at the half-rising time and at the peak of each spike-cluster, using individual head-models with six tissue-layers and a distributed source model (sLORETA). The fully automated approach presented ESI of the cluster with the highest number of spikes, at the half-rising time. In addition, a physician involved in the presurgical evaluation of the patients, evaluated the automated ESI results (up to four clusters per patient) in clinical context and selected the dominant cluster and the analysis time-point (semi-automated approach). The reference standard was location of the resected area and outcome one year after operation.Results
Accuracy was 61% (95% CI: 45–76%) for the fully automated approach and 78% (95% CI: 62–89%) for the semi-automated approach.Conclusion
Automated ESI has an accuracy similar to previously reported neuroimaging methods.Significance
Automated ESI will contribute to increased utilization of source imaging in the presurgical evaluation of patients with epilepsy. 相似文献18.
Christoph Czarnetzki André Truffert Abdelhafid Mekideche Antoine Poncet Christopher Lysakowski Martin R. Tramèr Michel R. Magistris 《Clinical neurophysiology》2018,129(1):51-58
Objective
To study whether the contraction evoked by muscle percussion stems from the excitation of the muscle or of the nerve and to discuss the changes of this response in neuromuscular disorders.Methods
In 30 neurologically healthy patients undergoing surgery (for ear, nose, or throat problems unrelated to the study) under general anesthesia with propofol and sufentanil we measured with an electrogoniometer the maximal dorsiflexion of the ankle evoked by reflex hammer percussion of the tibialis anterior muscle before and under neuromuscular junction blockade with rocuronium bromide. In 3 additional healthy volunteers we searched for F-waves to disclose whether percussion excites axons within the muscle.Results
Responses from 28 neurologically healthy patients (15 women) were analyzed after exclusion of 2 due to technical problems. Mean age (SD) was 28 (9) years. Maximal dorsiflexion of the ankle was not significantly modified by neuromuscular junction blockade (mean difference 0.01?mV [95%CI, ?0.07 to 0.08], p = 0.879). Muscle percussion evoked F-waves in the 3 healthy volunteers tested.Conclusions
Maximal contraction response to muscle percussion has a muscular rather than a neural origin. However, percussion also excites axons within the muscle.Significance
These findings may provide clues to understand the changes observed in neuromuscular disorders. 相似文献19.
Chisato Fujimoto Sayaka Suzuki Makoto Kinoshita Naoya Egami Keiko Sugasawa Shinichi Iwasaki 《Clinical neurophysiology》2018,129(1):238-245
Objective
To elucidate the clinical features and vestibular symptoms of patients with otolith organ dysfunction in the presence of normal function of the semicircular canals.Methods
We reviewed the clinical records of 277 consecutive new patients with balance disorders who underwent testing of cervical and ocular vestibular evoked myogenic potentials (cVEMPs and oVEMPs) as well as caloric testing and video head impulse testing (vHIT).Results
We identified 76 patients who showed normal caloric responses and normal vHIT findings in each SCC plane, but abnormal responses in cVEMP and/or oVEMP testing. Benign paroxysmal positional vertigo (BPPV) was the most common diagnosis. 37% of patients could not be categorized into any of the established clinical entities that could cause a balance disorder and did not show sensorineural hearing loss. The most common clinical manifestation in the idiopathic cases was recurrent rotatory vertigo with a duration of 1–12?h.Conclusions
The most common diagnosis of otolith organ-specific vestibular dysfunction was BPPV. The most common clinical manifestation in the idiopathic cases was recurrent rotatory vertigo.Significance
Specific dysfunction of the otolith organs occurs in association with some of the undiagnosed patients with recurrent rotatory vertigo. 相似文献20.
Sara Yagüe Misericordia Veciana Carlos Casasnovas Montserrat Ruiz Jordi Pedro Josep Valls-Solé Aurora Pujol 《Clinical neurophysiology》2018,129(3):507-515