Painful legs and moving toes

A 40-year-old woman reported involuntary and irregular movements of her left toes accompanied by pain. This arose following arthroscopy after a sprained left ankle. She had involuntary flexion–extension and abduction and adduction movements of the hallux and the other toes, with reduced pinprick sensation on the skin web between the left hallux and the second toe. Nerve conduction studies confirmed a deep peroneal nerve axonal injury. We diagnosed the syndrome of painful legs and moving toes, provoked by a peripheral nerve injury. Her symptoms have persisted despite pregabalin, gabapentin and amitriptyline.

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Neurophysiological assessments for peripheral nerve injury

10.1093/med/9780199682874.003.0038 ◽

2021 ◽

pp. 261-263

Author(s):

Arup Mallik

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Nerve Conduction ◽

Peripheral Nerve Injury ◽

Nerve Conduction Studies ◽

Anatomical Distribution

Neurophysiology is a useful investigation to assess peripheral nerve injury. It consists of nerve conduction studies and electromyography, providing information on anatomical distribution of the lesion (pre/postganglionic, single/multiple nerves), whether the lesion is primarily demyelinating or axonal, and whether the lesion is in continuity, as well as the overall prognosis.

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Establishment of a Sheep Model for Hind Limb Peripheral Nerve Injury: Common Peroneal Nerve

International Journal of Molecular Sciences ◽

10.3390/ijms22031401 ◽

2021 ◽

Vol 22 (3) ◽

pp. 1401

Author(s):

Rui D. Alvites ◽

Mariana V. Branquinho ◽

Ana C. Sousa ◽

Federica Zen ◽

Monica Maurina ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Peroneal Nerve ◽

Common Peroneal Nerve ◽

Small Sample ◽

Therapeutic Options ◽

Nerve Injuries ◽

Sheep Model ◽

The Common

Thousands of people worldwide suffer from peripheral nerve injuries and must deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee adequate outcomes, and the development of new and compelling therapeutic options require the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. The anatomy of the common peroneal nerve and topographically related nerves, the functional consequences of its injury and a neurological examination directed at this nerve have been described. Furthermore, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options were described. Finally, a preliminary morphological and stereological study was carried out to establish control values for the healthy common peroneal nerves regarding this animal model and to identify preliminary differences between therapeutic methods. This study allowed to define the described lateral incision as the best to access the common peroneal nerve, besides establishing 12 and 24 weeks as the minimum periods to study lesions of axonotmesis and neurotmesis, respectively, in this specie. The post-mortem evaluation of the harvested nerves allowed to register stereological values for healthy common peroneal nerves to be used as controls in future studies, and to establish preliminary values associated with the therapeutic performance of the different applied options, although limited by a small sample size, thus requiring further validation studies. Finally, this study demonstrated that the sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in humans and veterinary patients.

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Relapsing inflammatory neuropathy with normal peripheral nerve conduction studies – a paradoxical phenomenon in two patients

Journal of the Neurological Sciences ◽

10.1016/j.jns.2021.117768 ◽

2021 ◽

Vol 429 ◽

pp. 117768

Author(s):

Asha Kumarasiri ◽

Vithoosan Sahathevan ◽

Bimsara Senanayake

Keyword(s):

Peripheral Nerve ◽

Nerve Conduction ◽

Nerve Conduction Studies ◽

Paradoxical Phenomenon ◽

Inflammatory Neuropathy

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Establishment of a Sheep Model for Hind limb Peripheral Nerve Injury: Common Peroneal Nerve

10.20944/preprints202012.0567.v1 ◽

2020 ◽

Author(s):

Rui D. Alvites ◽

Mariana V. Branquinho ◽

Ana Catarina Sousa ◽

Federica Zen ◽

Monica Maurina ◽

...

Keyword(s):

Peripheral Nerve ◽

Nerve Injury ◽

Peripheral Nerve Injury ◽

Peroneal Nerve ◽

Hind Limb ◽

Common Peroneal Nerve ◽

Therapeutic Options ◽

Large Animal ◽

Sheep Model ◽

The Common

Thousands of people worldwide suffer from injuries in the peripheral nerve and deal daily with the resulting physiological and functional deficits. Recent advances in this field are still insufficient to guarantee effective outcomes, and the development of new and effective therapeutic options requires the use of valid preclinical models that effectively replicate the characteristics and challenges associated with these injuries in humans. In this study, we established a sheep model for common peroneal nerve injuries that can be applied in preclinical research with the advantages associated with the use of large animal models. In an integrative way, this article includes a detailed description of the anatomy and functionality of the peripheral nerves of sheep’s hind limb, the surgical protocol for accessing the common peroneal nerve, the induction of different types of nerve damage and the application of possible therapeutic options. A neurological exam protocol directed to the common peroneal nerve was also established, allowing to identify the changes and deficits related with the nerve injury and to evaluate the functional progression over time. Finally, a preliminary stereological study was carried out to establish control values for the healthy peroneal common nerves of this model and to identify preliminary differences between therapeutic methods. The ultimate goal is to demonstrate that sheep is a valid model of peripheral nerve injury to be used in pre-clinical and translational works and to evaluate the efficacy and safety of nerve injury therapeutic options before its clinical application in human and veterinary patients.

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Combined nerve conduction index in diabetic polyneuropathy

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2012000500005 ◽

2012 ◽

Vol 70 (5) ◽

pp. 330-334 ◽

Cited By ~ 3

Author(s):

Carlos Otto Heise ◽

Flavia Costa Nunes Machado ◽

Simone Consuelo de Amorim ◽

Sonia Maria de Toledo

Keyword(s):

Nerve Conduction ◽

Diabetic Polyneuropathy ◽

Nerve Conduction Studies ◽

The Other ◽

Diabetic Patients ◽

Lumbosacral Radiculopathy ◽

Standard Deviations ◽

Higher Sensitivity

Diabetic polyneuropathy can be confirmed by nerve conduction studies. The data can be analyzed in the form of a combined index instead of individual parameters. METHODS: The combined index included five parameters of nerve conduction studies commonly used for evaluation of polyneuropathies. We evaluated sensitivity in 100 diabetic patients with suspected polyneuropathy, and specificity in 200 non-diabetic patients with suspected lumbosacral radiculopathy. All results were expressed in number of standard deviations (SD). RESULTS: The sensitivity of the combined index was 81 or 74%, and specificity was 97 or 98%, using respectively -2.0 or -2.5 SD as cutoff. The range of sensitivity of the other parameters was 57-65% or 48-56%, and specificity range was 96-98% or 98-100%, using the same criteria. DISCUSSION: The combined index had higher sensitivity and equivalent specificity compared to isolated parameters.

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Improving the glial differentiation of human Schwann-like adipose-derived stem cells with graphene oxide substrates

Interface Focus ◽

10.1098/rsfs.2018.0002 ◽

2018 ◽

Vol 8 (3) ◽

pp. 20180002 ◽

Cited By ~ 9

Author(s):

Andrea Francesco Verre ◽

Alessandro Faroni ◽

Maria Iliut ◽

Claudio Silva ◽

Cristopher Muryn ◽

...

Keyword(s):

Gene Expression ◽

Stem Cells ◽

Graphene Oxide ◽

Peripheral Nerve ◽

Peripheral Nerve Injury ◽

Peripheral Nerve Regeneration ◽

The Other ◽

Adipose Derived Stem Cells ◽

Glial Differentiation ◽

Oxide Substrates

There is urgent need to improve the clinical outcome of peripheral nerve injury. Many efforts are directed towards the fabrication of bioengineered conduits, which could deliver stem cells to the site of injury to promote and guide peripheral nerve regeneration. The aim of this study is to assess whether graphene and related nanomaterials can be useful in the fabrication of such conduits. A comparison is made between graphene oxide (GO) and reduced GO substrates. Our results show that the graphene substrates are highly biocompatible, and the reduced GO substrates are more effective in increasing the gene expression of the biomolecules involved in the regeneration process compared to the other substrates studied.

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Peripheral nerve conduction studies and neuromuscular junction testing

Handbook of Clinical Neurophysiology - Clinical Neurophysiology of Motor Neuron Diseases ◽

10.1016/s1567-4231(04)04012-2 ◽

2004 ◽

pp. 241-270 ◽

Cited By ~ 1

Author(s):

Jun Kimura

Keyword(s):

Neuromuscular Junction ◽

Peripheral Nerve ◽

Nerve Conduction ◽

Nerve Conduction Studies

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Electrodiagnostic Findings in Neuromuscular Disorders

10.1093/med/9780190603434.003.0004 ◽

2018 ◽

Author(s):

Bashar Katirji

Keyword(s):

Neuromuscular Junction ◽

Peripheral Nerve ◽

Myasthenia Gravis ◽

Nerve Conduction ◽

Neuromuscular Disorders ◽

Nerve Conduction Studies ◽

Anterior Horn Cell ◽

Peripheral Neuropathies ◽

Peripheral Nerve Lesions ◽

Myasthenic Syndrome

Neuromuscular disorders are often classified into four major categories: anterior horn cell disorders, peripheral neuropathies, neuromuscular junction disorders and myopathies. This chapter discusses the electrodiagnostic and clinical EMG findings in these various neuromuscular disorders. Peripheral neuropathies are subdivided into focal mononeuropathies, radiculopathies, plexopathies and generalized peripheral polyneuropathies. Focal peripheral nerve lesions and generalized peripheral polyneuropathies may be axonal or demyelinating, and manifest quite distinctly on nerve conduction studies. Neuromuscular junction disorders may be presynaptic, as seen with the Lambert-Eaton myasthenic syndrome, or postsynaptic, as seen with myasthenia gravis.

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