scholarly journals DIAGNOSTICS OF NERVE IMPULSES TRANSMISSION PATHOLOGY IN PATIENTS WITH SUSPECTED THORACIC OUTLET SYNDROME USING CLINICAL NEUROPHYSIOLOGY TESTS

2021 ◽  
Vol 35 (35) ◽  
pp. 61-66
Author(s):  
Agata Maria Kaczmarek ◽  
Anna Kalek ◽  
Paulina Wietrzak ◽  
Juliusz Huber
Keyword(s):  
Evoked Potentials ◽  
Diagnostic Tests ◽  
Thoracic Outlet Syndrome ◽  
Clinical Neurophysiology ◽  
Clinical Symptoms ◽  
Motor Evoked Potentials ◽  
Upper Extremities ◽  
Control Group ◽  
Nerve Impulses ◽  
Lower Neck

Introduction Thoracic Outlet Syndrome (TOS) is a group of conditions characterized by compression of the nerves, arteries and veins in the lower neck and upper chest area. On average, six physicians of different specialities need 4.3 years to develop TOS diagnosis. Early detection of changes in transmission of nerve impulses within the brachial plexus may lead to faster and more effective treatment of patients. Aim The aim of the study is to present the scheme of diagnostic tests of clinical neurophysiology contributing to the objective diagnosis of TOS, as well as the positive results of tests in a group of sixteen patients with clinically confirmed pathological symptoms. Material and methods Sixteen patients with clinically diagnosed TOS and sixteen healthy people as a control group aged from 18 to 36 participated in this study. In both groups of subjects, bilateral clinical neurophysiological diagnostics tests were carried out: an examination of the sensory perception with von Frey’s filaments within C4-C8 dermatomes, examination of surface electromyography (sEMG) during maximal contractions when recordings from proximal and distal muscles of the upper extremities were performed, the electroneurographic transmission of nerve impulses in selected nerves of the upper extremities (ENG) and motor evoked potentials recordings induced with the magnetic field (MEP) following oververtebral C5 and C6 stimulation. Results Comparing to studies performed in a control group of healthy volunteers, more than 50% of patients with clinical symptoms of TOS had confirmed abnormalities in the diagnostic tests of clinical neurophysiology, unilaterally or bilaterally. Conclusions In the diagnosis of TOS, sEMG recordings from the distal muscles of upper extremities during maximal contractions after induction of ischemia (“hand-raised test”), ENG segmental examination of nerve impulses transmission in motor fibers after stimulation of the median and ulnar nerves, and MEP examination after oververtebral C5 and C6 stimulation are particularly useful. Confirmation of a relatively high percentage of positive TOS tests in patients requires a greater number of neurophysiological examinations. Keywords: Thoracic Outlet Syndrome, neurophysiological diagnostics, motor evoked potentials

scholarly journals Motor Evoked Potentials of the Upper Extremities in Healthy Children

2011 ◽  
Vol 35 (6) ◽  
pp. 759 ◽  
Author(s):  
Soon-Won Yook ◽  
Sung-Hee Park ◽  
Myoung-Hwan Ko ◽  
Jeong-Hwan Seo
Keyword(s):  
Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Upper Extremities ◽  
Healthy Children

Corticospinal Excitability of the Ankle Extensor Muscles Is Enhanced in Ballet Dancers

2014 ◽  
Vol 29 (3) ◽  
pp. 144-149 ◽  
Author(s):  
Sakiko Saito ◽  
Hiroki Obata ◽  
Takashi Endoh ◽  
Mayumi Kuno-Mizumura ◽  
Kimitaka Nakazawa
Keyword(s):  
Evoked Potentials ◽  
Soleus Muscle ◽  
Motor Evoked Potentials ◽  
Regression Line ◽  
Corticospinal Excitability ◽  
Control Group ◽  
Electromyographic Activity ◽  
Plantar Flexors ◽  
Ballet Dancers

We tested the corticospinal excitability of the soleus muscle in ballet dancers to clarify whether the presumed long-term repetition of the specific plantarflexion results in changes of excitability in this neural pathway. We compared motor evoked potentials of the soleus muscle at rest and during isometric contraction of the plantar flexors in dancers and nondancers. The amplitudes of motor evoked potentials elicited by transcranial magnetic stimulation during contraction were examined against the background electromyographic activity. A regression line was calculated for each subject. Results showed that the slope of the regression line is significantly greater in the dancer group than in the control group, suggesting that the corticospinal tract of ballet dancers has adapted to long-term repetition of plantarflexion in daily ballet training.

Noninvasive Intraoperative Monitoring of Motor Evoked Potentials under Propofol Anesthesia: Effects of Spinal Surgery on the Amplitude and Latency of Motor Evoked Potentials

Neurosurgery ◽  
1991 ◽  
Vol 29 (4) ◽  
pp. 551-557 ◽  
Author(s):  
David Jellinek ◽  
Doreen Jewkes ◽  
Lindsay Symon
Keyword(s):  
Evoked Potentials ◽  
Spinal Surgery ◽  
Intraoperative Monitoring ◽  
Motor Evoked Potentials ◽  
Control Group ◽  
Transcranial Electrical Stimulation ◽  
Neurosurgical Procedures ◽  
Spinal Arteriovenous Malformation ◽  
Baseline Values ◽  
Dorsal Interosseous Muscle

Abstract We present the results of intraoperative monitoring of motor evoked potentials from 34 patients undergoing spinal surgery under total anesthesia with intravenously administered propofol. intraoperative recording was performed with transcranial electrical stimulation. Two groups of patients were studied: 1) a control population of 26 patients undergoing lumbar discectomy for prolapsed intervertebral disc, all of whom had normal preoperative motor conduction; and 2) a population of 8 patients undergoing neurosurgical procedures for spinal tumor (5 patients) and spinal arteriovenous malformation (3 patients), all of whom had abnormal preoperative neurological signs and abnormal preoperative motor conduction. In the first group, electromyographic responses were recorded intraoperatively either from the 2nd dorsal interosseous muscle of the hand (5 patients) or from the 1st dorsal interosseous muscle of the foot (21 patients). In the second group, responses were recorded intraoperatively either from the 1st dorsal interosseous muscle of the foot (7 patients) or from the anterior tibial muscle (1 patient). Intraoperative monitoring of motor function was successful in 88.5% of the patients in the control group. Propofol anesthesia caused a reduction in response amplitude to 7% of baseline values obtained from conscious relaxed subjects. Intraoperative monitoring was successful in 87% of the patients in the pathological group. We observed significant changes in both amplitude (>50%) and/or onset latency (>3 ms) from the intraoperative baseline that indicated cither improvement (3 patients) or deterioration (2 patients) in motor conduction within minutes of surgical maneuvers anticipated to alter spinal cord function. Only permanent complete loss of intraoperative motor conduction (1 patient) correlated with a significant change in the postoperative neurological state. We conclude 1) that changes in latency as well as amplitude are useful evaluation criteria of intraoperative motor evoked potentials, and 2) that even in the presence of significant intraoperative deterioration in motor conduction, subsequent recovery of motor conduction toward baseline values during anesthesia is a favorable prognostic sign.

scholarly journals REVIEW ON METHODOLOGY AND INTERPRETATION OF RESULTS OF MOTOR EVOKED POTENTIALS INDUCED WITH MAGNETIC FIELD OR ELECTRICAL STIMULI RECORDED PREOPERATIVELY OR INTRAOPERATIVELY

2021 ◽  
pp. 33-42
Author(s):  
Anna Garasz ◽  
Juliusz Huber
Keyword(s):  
Magnetic Field ◽  
Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Clinical Diagnostics ◽  
Control Group ◽  
Time Duration ◽  
Lumbar Level ◽  
Electrical Stimuli ◽  
The Magnetic Field ◽  
Pilot Tests

Introduction The method of motor evoked potentials recordings induced with magnetic field (MEP) (as part of the differential diagnosis of disease in the musculoskeletal system before the introduction of treatment) and motor evoked potentials induced with electrical stimuli (during intraoperative neuromonitoring) is particularly intensively used among clinical neurophysiology studies in the last twenty years. Aim The aim of the study is to review the practical usefulness of MEP in clinical diagnostics and present the most common examples of the application of this method, the possibility of modifications aimed at increasing non-invasiveness, safety and diagnostic precision. Material and methods The results of pilot tests of different variants of MEP recordings are presented preoperatively from muscles and nerves of the lower extremities in healthy volunteers (N = 10) and patients with disc-root conflicts (N = 15). Results Pilot tests show that in healthy people after oververtebral stimulation with the magnetic field at the lumbar level, the MEP amplitude and latency parameters recorded from nerves compared to those recorded from muscles are characterized by lower values (amplitudes by about 50%, latencies with mean at about 3 ms) and the time duration is increased by approximately 20%. The variability of MEP parameters is similar in patients with disc-root conflict in preoperative diagnostics, even though mean amplitude values from muscles were lower in comparison to healthy control group. Conclusions The MEP recording method from nerves vs. muscles after oververtebral stimulation with the magnetic field at the lumbar level in patients with disc-root conflict is diagnostically essential in cases of visible atrophic changes in muscles with symptoms of slight pathology in the transmission of nerve impulses in motor axons. Keywords: motor evoked potentials, neurophysiological diagnostics, neuromonitoring, methodological modifications

Motor Evoked Potentials in the Upper Extremities of Children with Spastic Hemiplegic Cerebral Palsy

2019 ◽  
Vol 12 (2) ◽  
Author(s):  
Da-Sol Kim ◽  
Eu-Deum Kim ◽  
Gi-Wook Kim ◽  
Yu Hui Won ◽  
Myoung-Hwan Ko ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Upper Extremities ◽  
Hemiplegic Cerebral Palsy

scholarly journals Physiotherapy Approaches in the Treatment of Ataxic Multiple Sclerosis: A Pilot Study

2001 ◽  
Vol 15 (3) ◽  
pp. 203-211 ◽  
Author(s):  
Kadriye Armutlu ◽  
Rana Karabudak ◽  
Gülay Nurlu
Keyword(s):  
Multiple Sclerosis ◽  
Evoked Potentials ◽  
Motor Evoked Potentials ◽  
Control Group ◽  
Study Group ◽  
Conduction Time ◽  
Expanded Disability Status Scale ◽  
Gait Parameters ◽  
Significant Difference ◽  
Disability Status

Objective: This study was planned to investigate the efficacy of neuromuscular rehabilitation and Johnstone Pressure Splints in the patients who had ataxic multiple sclerosis. Methods: Twenty-six outpatients with multiple sclerosis were the subjects of the study. The control group (n = 13) was given neuromuscular rehabilitation, whereas the study group (n = 13) was treated with Johnstone Pressure Splints in ad dition. Results: In pre- and posttreatment data, significant differences were found in sensation, anterior balance, gait parameters, and Expanded Disability Status Scale (p < 0.05). An important difference was observed in walking-on-two-lines data within the groups (p < 0.05). There also was a statistically significant difference in pendular movements and dysdiadakokinesia (p < 0.05). When the posttreatment values were compared, there was no significant difference between sensation, anterior balance, gait parameters, equilibrium and nonequilibrium coordination tests, Expanded Disability Status Scale, cortical onset latency, and central conduction time of somatosensory evoked potentials and motor evoked potentials (p > 0.05). Comparison of values re vealed an important difference in cortical onset-P37 peak amplitude of somatosen sory evoked potentials (right limbs) in favor of the study group (p < 0.05). Conclu sions : According to our study, it was determined that physiotherapy approaches were effective to decrease the ataxia. We conclude that the combination of suitable phys iotherapy techniques is effective multiple sclerosis rehabilitation. Key Words: Multi ple sclerosis—Ataxia—Physical therapy.

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