scholarly journals Comparison of The Electrophysiological Characteristics of Tight Filum Terminale And Tethered Cord Syndrome

2021 ◽  
Author(s):  
Naosuke Kamei ◽  
Toshio Nakamae ◽  
Kazuyoshi Nakanishi ◽  
Taiki Morisako ◽  
Takahiro Harada ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Motor Evoked Potential ◽  
Tethered Cord ◽  
Compound Action Potential ◽  
Conduction Time ◽  
Filum Terminale ◽  
Abductor Hallucis ◽  
Abductor Pollicis Brevis ◽  
Compound Muscle Action Potentials ◽  
Tight Filum Terminale

Abstract This study aims to characterize tight filum terminale (TFT) in motor evoked potential (MEP) testing by comparing TFT patients with both tether cord syndrome (TCS) patients and healthy subjects. Fifty TFT patients, 18 TCS patients, and 35 healthy volunteers participated in this study. We recorded MEPs following transcranial magnetic stimulation from the bilateral abductor hallucis muscles as well as compound muscle action potentials and F-waves evoked by electrical stimulation of the tibial nerve from the bilateral abductor pollicis brevis muscles. The peripheral conduction time (PCT) was calculated from the latency of the compound action potential and F-wave. Furthermore, the central motor conduction time (CMCT) was calculated by subtracting PCT from MEP latency. TFT and TCS patients had a significantly longer MEP latency than healthy subjects. PCT in TFT patients were significantly longer than those in TCS patients or healthy subjects. Using the cut-off values for PCT, we were able to diagnose patients with TFT patients with a sensitivity of 72.0% and a specificity of 91.4%. Prolonged PCT in the MEP test may be a useful indicator for TFT and suggests that MEP may be used as an adjunct diagnostic tool for TFT.

scholarly journals Peculiarities of motor evoked potential in healthy children of different age

2019 ◽  
Vol 19 (4) ◽  
pp. 228-231
Author(s):  
Vladislav B. Voitenkov ◽  
N. V. Skripchenko ◽  
A. V. Klimkin ◽  
A. I. Aksenova
Keyword(s):  
Normative Data ◽  
Evoked Potential ◽  
Motor Evoked Potentials ◽  
Pediatric Population ◽  
Motor Evoked Potential ◽  
Conduction Time ◽  
Healthy Children ◽  
Abductor Hallucis ◽  
Abductor Pollicis Brevis ◽  
Pediatric Disorders

Aim of the work The implementation of the database for reference values of motor evoked potentials (MEP) in healthy children of different ages. Methods 95 healthy children were enrolled. Age ranged from 1 to 204 months. Three subgroups were established: children of 1-12 months (n=31, 18 males, 13 females), 12-144 months (n=27, 14 males, 13 females) and 144-204 (n=37, 20 males, 17 females) months. All children were healthy. Diagnostic transcranial magnetic stimulation (TMS) was performed in all patients. MEP shape, threshold, latency and amplitudes were recorded for hands (m. Abductor pollicis brevis) and legs (m. Abductor Hallucis). Central motor conduction time (CMCT) was calculated. Results. Along with age there was observed the elongation of MEP latency, gain in amplitudes and shape normalization. There were significant differences in the elongation of MEP latency between children aged of 1-12 months and children from two other subgroups (12-144 and 144-204 months). Conclusions. Our normative data can be usedfor comparative studies in the broad spectrum of pediatric disorders. Age restrictions have to be taken in a consideration when performing the TMS in pediatric population.

Symptomatic Retethering of the Spinal Cord After Section of a Tight Filum Terminale

Neurosurgery ◽  
2011 ◽  
Vol 68 (6) ◽  
pp. 1594-1602 ◽  
Author(s):  
Raymund L. Yong ◽  
Tracey Habrock-Bach ◽  
Mariko Vaughan ◽  
John R. Kestle ◽  
Paul Steinbok
Keyword(s):  
Tethered Cord ◽  
Invasive Procedure ◽  
Pediatric Neurosurgery ◽  
Filum Terminale ◽  
Initial Surgery ◽  
Long Term Follow Up ◽  
Initial Procedure ◽  
Tight Filum Terminale

Abstract BACKGROUND: Section of a tight filum terminale is a minimally invasive procedure compared with cord untethering procedures used for more complex spinal abnormalities. Anecdotal evidence suggests, however, that the risk of symptomatic retethering resulting from scarring might be higher than previously thought. OBJECTIVE: To determine the frequency of symptomatic retethering after section of a tight filum terminale and to explore possible risk factors. METHODS: We reviewed databases at 2 pediatric neurosurgery centers for all patients who had surgery for a suspected tight filum terminale between January 1982 and June 2009. RESULTS: We identified 152 patients. The median length of follow-up was 78 months. Thirteen patients (8.6%) went on to retether symptomatically at a median time of 23.4 months after the initial procedure. Eight had early retethering (within 2 years) and 5 had late retethering (after 7 years). Compared with late retetherers, early retetherers were older at initial surgery (median, 9.4 vs 0.9 years of age), had a higher level of the conus (median, L1/L2 vs L3/L4), had more arachnoiditis after initial surgery, and required more repeat untethering procedures. Late retetherers were younger at initial surgery than those who did not retether (median, 0.9 vs 4.5 years of age). CONCLUSION: Symptomatic retethering is not uncommon after a simple filum snip, and long-term follow-up is warranted. Two distinct patterns of retethering were observed. Arachnoiditis caused by infection or a cerebrospinal fluid fistula may predispose to early retethering, whereas early surgery for prevention of tethered cord symptoms may predispose to late retethering.

Electrophysiological Evaluation and Clinical Implication of Martin-Gruber Anastomosis in Healthy Subjects

2020 ◽  
Vol 25 (01) ◽  
pp. 87-94
Author(s):  
Mohamed Hefny ◽  
Asser Sallam ◽  
Maii Abdellatif ◽  
Shaimaa Okasha ◽  
Marwa Orabi
Keyword(s):  
Healthy Subjects ◽  
Anatomic Variation ◽  
Electrophysiological Study ◽  
Mean Amplitude ◽  
Sensory Loss ◽  
Abductor Pollicis Brevis ◽  
Motor Action ◽  
Compound Muscle Action Potentials ◽  
Abductor Digiti Minimi ◽  
The Right

Background: The aim of this study is to determine the prevalence of Martin-Gruber Anastomosis (MGA) in healthy Egyptian subjects, and to discuss the available literature regarding MGA subtypes and their clinical implications. Methods: An electrophysiological study was conducted in both forearms of 140 healthy subjects. This included the ulnar and median nerves. Compound muscle action potentials were recorded from abductor pollicis brevis, abductor digiti minimi, and first dorsal interosseous muscles. Other measurements included the compound motor action potential amplitude and its innervation ratio. Results: MGA was found in 56 of the 280 forearms. This included 20 men and 36 women. Type II MGA subtype was the most frequent in both genders. The MGA was bilateral in 6 subjects and more frequent on the right side. The highest mean amplitude and innervation ratio were recorded at first dorsal interosseus muscle. Conclusions: The prevalence of MGA in the studied sample of the Egyptian population is 20%. It is important for Hand, Orthopaedic and Neurosurgeons to be aware of this anatomic variation in order to explain paradoxical motor and sensory loss in patients.

scholarly journals Real spinal cord injury without radiologic abnormality in pediatric patient with tight filum terminale following minor trauma: a case report

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Qin Chuan Liang ◽  
Bo Yang ◽  
Yun Hai Song ◽  
Pin Pin Gao ◽  
Ze Yang Xia ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Clinical Symptoms ◽  
Tethered Cord ◽  
Trauma Patients ◽  
Minor Trauma ◽  
Filum Terminale ◽  
Predisposing Factor ◽  
Cord Injury ◽  
Tight Filum Terminale

Abstract Background Spinal cord injury without radiographic abnormality (SCIWORA) is defined as having “clinical symptoms of traumatic myelopathy with no radiographic or computed tomographic features of spinal fracture or instability”. The mechanism of pediatric SCIWORA following minor trauma is still unclear. Tight filum terminale (TFT) has been studied in the literature, but the information regarding the predisposing factor for SCIWORA is still being defined. Case presentation We report three cases of thoracic and lumber SCIWORA with TFT. The trauma was potentially mild in all cases but resulted in catastrophic damage of the cord. All patients had no signs or symptoms of tethered cord syndrome prior to the minor trauma. TFT was found during operation. Conclusions We suggest that TFT might be a predisposing factor for SCIWORA and chronic spinal cord traction play an important role in the mechanism of pediatric thoracic and lumber SCIWORA following minor trauma. Patients who never undergo treatment for TFT likely have an elevated risk of developing SCIWORA following minor trauma.

Preventing cerebrospinal fluid leak following transection of a tight filum terminale

2011 ◽  
Vol 8 (1) ◽  
pp. 35-38 ◽  
Author(s):  
Joshua J. Chern ◽  
R. Shane Tubbs ◽  
Akash J. Patel ◽  
Amber S. Gordon ◽  
S. Kathleen Bandt ◽  
...  
Keyword(s):  
Univariate Analysis ◽  
Operating Time ◽  
Tethered Cord ◽  
Cerebrospinal Fluid Leak ◽  
Csf Leak ◽  
Complication Rates ◽  
Filum Terminale ◽  
Csf Leakage ◽  
Tight Filum Terminale ◽  
The Individual

Object Tethered cord release for a tight filum terminale is a common pediatric operation associated with low morbidity and mortality rates. While almost all would agree that keeping patients lying flat after the operation will prevent a CSF leak, the optimal period of doing so has not been determined. In this study, the authors examined whether a longer length of stay in the hospital for the sole purpose of maintaining patients flat correlates with a decreased rate of CSF leakage. Methods Intraoperative and postoperative data were retrospectively collected in 222 cases of simple tethered cord release at 3 large children's hospitals. Risk factors for postoperative CSF leakage were identified. Results Thirty-eight patients were maintained lying flat for 24 hours, 86 for 48 hours, and 98 for 72 hours at the individual surgeon's discretion. A CSF leak occurred in 13 patients (5.9%) and pseudomeningocele developed in 9 patients (4.1%). In the univariate analysis, operating time, use of the microscope, use of dural sealant, and duration of remaining flat after surgery failed to correlate with the occurrence of complications. Conclusions A longer hospital stay for maintaining patients flat after a simple tethered cord release appears not to prevent CSF leakage. However, a larger patient cohort will be needed to detect small differences in complication rates.

Growth Acceleration Following Tethered Cord Release in Symptomatic Children With Tight Filum Terminale Syndrome

Neurosurgery ◽  
2010 ◽  
Vol 67 (2) ◽  
pp. 555-555
Author(s):  
Kimberly A. Foster ◽  
Sandi Karen Lam ◽  
Yue-Fang Chang ◽  
Stephanie Greene
Keyword(s):  
Tethered Cord ◽  
Filum Terminale ◽  
Tight Filum Terminale

The Effect of Tethered Cord Release on Coronal Spinal Balance in Tight Filum Terminale

Spine ◽  
2011 ◽  
Vol 36 (14) ◽  
pp. E944-E949 ◽  
Author(s):  
Joshua J. Chern ◽  
Robert C. Dauser ◽  
William E. Whitehead ◽  
Daniel J. Curry ◽  
Thomas G. Luerssen ◽  
...  
Keyword(s):  
Tethered Cord ◽  
Filum Terminale ◽  
Spinal Balance ◽  
Tight Filum Terminale

scholarly journals Diaphragmatic Central Motor Conduction Changes In Chronic Obstructive Pulmonary Disease

2019 ◽  
Author(s):  
Rehab Abdelaal El-Nemr ◽  
Rania Ahmad Sweed ◽  
Hanaa Shafiek
Keyword(s):  
Pulmonary Function ◽  
Healthy Subjects ◽  
Magnetic Stimulation ◽  
Motor System ◽  
Evoked Potential ◽  
Group Versus ◽  
Motor Evoked Potential ◽  
Conduction Time ◽  
Copd Patients ◽  
Resting Motor Threshold

AbstractBackground and objectivesRespiratory muscles dysfunction has been reported in COPD. Transcranial magnetic stimulation (TMS) is easy non-invasive that has been used for assessing the respiratory corticospinal pathways particularly of diaphragm. We aimed to study the cortico-diaphragmatic motor system changes in COPD using TMS and to correlate the findings with the pulmonary function.MethodsA case control study recruited 30 stable COPD from the out-patient respiratory clinic of Main Alexandria University hospital-Egypt and 17 healthy control subjects who were subjected to spirometry. Cortical conduction of the diaphragm was performed by TMS to all participants followed by cervical magnetic stimulation of the phrenic nerve roots. Diaphragmatic resting motor threshold (DRMT), cortical motor evoked potential latency (CMEPL), CMEP amplitude (CMEPA), peripheral motor evoked potential latency (PMEPL), PMEP amplitude (PMEPA) and central motor conduction time (CMCT) were measured.Results66.7% of COPD patients had severe and very severe COPD with median age of 59 (55-63) years. There was statistically significant bilateral decrease in DRMT, CMEPA and PMEPA in COPD group versus healthy subjects and significant increase in CMEPL and PMEPL (p <0.01). Left CMCT was significantly prolonged in COPD group versus healthy subjects (p <0.0001) but not right CMCT. Further, there was significant increase in CMEPL and CMCT of left versus right diaphragm in COPD group (p= 0.003 and 0.001 respectively) that inversely correlated with FEV1% and FVC% predicted.ConclusionCentral cortico-diaphragmatic motor system is affected in COPD patients with heterogeneity of both sides that is correlated with pulmonary function.SignificanceCoticospinal pathway affection could be a factor for development of diaphragmatic dysfunction in COPD patients accordingly its evaluation could help in personalization of COPD management especially pulmonary rehabilitation programs

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