Cervical spondylosis as a possible hidden reason beyond delayed phrenic nerve distal motor latency

Abstract Background Cervical spondylosis is a chronic degenerative condition of the cervical spine that can affect the cervical nerve roots. The origin of the phrenic nerve makes it vulnerable to injury. The purpose of this study is to investigate possible subtle phrenic nerve affection in patients with cervical spondylosis using nerve conduction studies (NCS). This study was conducted on 30 patients with cervical spondylosis above C5 and on 30 healthy volunteers. Nerve conduction studies of both phrenic nerves were performed in all cases. Results The patients with cervical spondylosis showed a statistically highly significant prolongation of phrenic nerve distal motor latency (DML) than the control group (P < 0.01). There was no significant difference regarding amplitude (P > 0.05). There was a significant correlation between DML and X-ray score (r < 0.05). Conclusions Cervical spondylosis is an underestimated cause of phrenic nerve delayed DML. There is a correlation between the delay of phrenic nerve DML and the severity of cervical spondylosis.

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Neurophysiological Recovery After Open Carpal Tunnel Decompression: Comparison of Simple Decompression and Decompression with Epineurotomy

Journal of Hand Surgery (European Volume) ◽

10.1016/s0266-7681(03)00152-9 ◽

2003 ◽

Vol 28 (5) ◽

pp. 450-454 ◽

Cited By ~ 33

Author(s):

N. BORISCH ◽

P. HAUSSMANN

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Carpal Tunnel Release ◽

Nerve Conduction Studies ◽

Motor Latency ◽

Significant Difference ◽

Tunnel Syndrome ◽

Open Carpal Tunnel Release ◽

Simple Decompression

Two hundred and seventy-three patients with carpal tunnel syndrome without advanced neurophysiological changes (distal motor latency below 11 ms) were randomized to treatment by open carpal tunnel release with, or without, epineurotomy. Patients were examined clinically and by nerve conduction studies preoperatively and at 3, 6 and 12 months postoperatively. We found no statistically significant difference between simple decompression and decompression combined with epineurotomy with regard to either the clinical or the neurophysiological outcome.

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Utility of phrenic nerve conduction studies for identification of patients with neuromuscular diseases requiring invasive mechanical ventilation

Muscle & Nerve ◽

10.1002/mus.27449 ◽

2021 ◽

Author(s):

Shinya Narukawa ◽

Keita Ishizuka ◽

Kohei Sugimoto ◽

Kyoichi Nomura

Keyword(s):

Mechanical Ventilation ◽

Phrenic Nerve ◽

Nerve Conduction ◽

Invasive Mechanical Ventilation ◽

Neuromuscular Diseases ◽

Nerve Conduction Studies

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When is needle examination of thenar muscle necessary in the evaluation of mild and moderate carpal tunnel syndrome?

Turkish Journal of Physical Medicine and Rehabilitation ◽

10.5606/tftrd.2021.8555 ◽

2021 ◽

Vol 67 (4) ◽

pp. 518-525

Author(s):

Zuhal Özişler ◽

Müfit Akyüz

Keyword(s):

Carpal Tunnel Syndrome ◽

Spontaneous Activity ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Sensory Nerve ◽

Symptom Duration ◽

Thenar Muscle ◽

Distal Motor Latency ◽

Motor Latency ◽

Tunnel Syndrome

Objectives: This study aims to evaluate the predictors of standard nerve conduction study (NCS) parameters in determining the presence of axonal loss by means of spontaneous activity in patients with mild and moderate carpal tunnel syndrome (CTS). Patients and methods: Between May 2015 and April 2018, a total of 118 patients (11 males, 107 females; mean age: 52.3±10.6 years; range, 27 to 79 years) who underwent electrophysiological studies and were diagnosed with CTS were included. Demographic data of the patients including age, sex, and symptom duration were recorded. Electrodiagnostic studies were performed in all patients. All the needle electromyography (EMG) findings were recorded, but only the presence or absence of spontaneous EMG activities was used as the indicator of axonal injury. Results: In 37 (31.4%) of the patients, spontaneous activity was detected at the thenar muscle needle EMG. No spontaneous activity was observed in any of 43 (36.4%) patients with normal distal motor latency (DML). There were significant differences in DMLs, compound muscle action potential (CMAP) amplitudes, sensory nerve action potentials amplitudes, and sensory nerve conduction velocities between the groups with and without spontaneous activity (p<0.05). The multiple logistic regression analysis revealed that DML was a significant independent risk variable in determining presence of spontaneous activity. The most optimal cut-off value for median DML was calculated as 4.9 ms. If the median DML was >4.9 ms, the relative risk of finding spontaneous activity on thenar muscle needle EMG was 13.5 (95% CI: 3.6-51.2). Conclusion: Distal motor latency is the main parameter for predicting the presence of spontaneous activity in mild and moderate CTS patients with normal CMAP. Performing needle EMG of the thenar muscle in CTS patients with a DML of >4.9 ms may be beneficial to detect axonal degeneration in early stages.

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Visualization of the diaphragm muscle with ultrasound improves diagnostic accuracy of phrenic nerve conduction studies

Muscle & Nerve ◽

10.1002/mus.24059 ◽

2014 ◽

Vol 49 (5) ◽

pp. 669-675 ◽

Cited By ~ 12

Author(s):

Nicholas E. Johnson ◽

Michael Utz ◽

Erica Patrick ◽

Nicole Rheinwald ◽

Marlene Downs ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Phrenic Nerve ◽

Nerve Conduction ◽

Nerve Conduction Studies ◽

Diaphragm Muscle

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Nerve Conduction Studies in Patients with Lumbosacral Radiculopathy Caused by Lumbar Intervertebral Disc Herniation

Advances in Orthopedics ◽

10.1155/2020/8882387 ◽

2020 ◽

Vol 2020 ◽

pp. 1-6

Author(s):

Safa Yousif ◽

Ammar Ahmed ◽

Ahmed Abdelhai ◽

Afraa Musa

Keyword(s):

Nerve Conduction Study ◽

Nerve Conduction ◽

Tibial Nerve ◽

Motor Nerve ◽

H Reflex ◽

Nerve Conduction Studies ◽

Control Group ◽

Motor Nerve Conduction ◽

Lumbosacral Radiculopathy ◽

F Wave

Background. Nerve conduction studies (NCS) are electrodiagnostic tests used to evaluate peripheral nerves functions and aid in the assessment of patients with neuromuscular complaints. There is contrasting evidence concerning the use of NCS in the assessment of patients with lumbosacral radiculopathy. Objectives. This study was conducted to evaluate nerve conduction studies abnormalities in patients with lumbosacral radiculopathy and to find out their relation to abnormal physical examination findings. Materials and Methods. Twenty-seven patients with lumbosacral radiculopathy caused by L4/5 or L5/S1 intervertebral disc prolapse confirmed by magnetic resonance imaging (MRI) were recruited in the study. Twenty-five healthy subjects matched in age and sex served as control. Motor nerve conduction study bilaterally for both common peroneal and tibial nerves, F-wave for both nerves, and H-reflex had been conducted. Results. No significant difference was found in the motor nerve conduction study parameters (latency, amplitude, and conduction velocity) between the patients group and the control group. There was significant prolongation in H-reflex latency of both symptomatic and asymptomatic side in the patients group compared to the control group ( P < 0.05 ). Also, F-wave latencies (F minimum, F maximum, and F mean) of the tibial nerve were significantly prolonged ( P < 0.05 ) compared to control. Conclusion. Prolonged H-reflex latency was the commonest encountered abnormality in our study followed by F-wave latencies of the tibial nerve.

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Use of Nerve Conduction Studies and the Pressure-Specified Sensory Device in the Diagnosis of Carpal Tunnel Syndrome

Journal of Hand Surgery (European Volume) ◽

10.1177/1753193408094921 ◽

2009 ◽

Vol 34 (1) ◽

pp. 60-65 ◽

Cited By ~ 8

Author(s):

D. J. SLUTSKY

Keyword(s):

Carpal Tunnel Syndrome ◽

Carpal Tunnel ◽

Nerve Conduction ◽

Diagnostic Yield ◽

Carpal Tunnel Release ◽

Nerve Conduction Studies ◽

Control Group ◽

Asymptomatic Volunteers ◽

Before And After ◽

Tunnel Syndrome

Sixty-nine patients with signs of carpal tunnel syndrome (CTS) underwent nerve conduction studies (NCS) and testing with the Pressure-Specified Sensory Device (PSSD). A total of 102 tests were performed (28 bilateral). Twenty patients underwent a carpal tunnel release and were retested after 4 to 6 months. The Symptom Severity Score (SSS) was calculated before and after surgery. A control group of 20 hands in 10 asymptomatic volunteers underwent identical testing. The NCS sensitivity was 87% with a specificity of 90% whereas the PSSD sensitivity was 81% with a specificity of 65%. The combined sensitivity of the two tests was 93%. In the operative group the SSS improved from a mean of 3.34 pre-operatively to 1.95 postoperatively. The NCS improved in 19/21 hands whereas the PSSD improved in 16/19 hands. The non-invasive SSS and PSSD can increase the diagnostic yield in CTS, especially when the NCS are normal.

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