Comparison of Usefulness of Laboratory Tests in Diagnosis of Myasthenia Gravis / 영남의대학술지

PURPOSE: This study was undertaken to evaluate the clinical usefulness of Tensilon test, repetitive nerve stimulation test(RNST), single fiber EMG(SFEMG) test and acetylcholine receptor antibody(AchR Ab) assay for making diagnosis of myasthenia gravis(MG). METHOD: These tests were performed in 21 MG patients which were classified into 11 ocular, 5 mild generalized, 4 moderate generalized, and 1 chronic severe MG. RESULT: The overall positivity of Tensilon test, SFEMG and AchR Ab was 95%, 87%, and 76% respectively. The overall positivity of RNST was 67%; 38% on flexor carpi ulnaris, 43% on adductor digiti quinti and 62% on orbicularis oculi muscles. The positivity of each test was higher in generalized MG group than in ocular MG group. But we could observe the statistically significant difference only in the RNST(p<0.05). CONCLUSION: Tensilon test showed the highest positivity in all MG groups. So we would like to recommend the Tensilon test for the diagnosis of MG at first, followed by RNST and AchR Ab assay, and SFEMG would be indicated to MG group which showed relatively low postivity in other tests.

Localization of Ulnar Neuropathy at the Elbow by Short Segment Stimulation

BACKGROUND AND OBJECTIVES: Local compression of the ulnar nerve occurs most commonly at the elbow and optimal surgical intervention should be directed at the specific site of involvement. This study is designed to localize the more discrete region by using the method of short segment stimulation in ulnar neuropathy at the elbow. METHODS: Thirty seven patients who were diagnosed as entrapment ulnar neuropathy at the elbow by routine nerve conduction studies were investigated. Latency changes and amplitude changes including conduction block were determined by stimulating the ulnar nerve at 2cm intervals across the elbow. Six of these patients had orthopedic surgery after undergoing short segment stimulation studies. RESULT: All patients had significant latency changes(> OR =0.7msec) in specific segments by short segment stimulation and 6 patients of them showed conduction block. The most frequently involved segments were between medial epicondyle and 2cm proximal(20 patients) and between medial epicondyle and 2cm distal(9 patients). Only two patients exhibited significant latency changes between 2 and 4cm distal to the medial epicondyle, suggesting cubital tunnel syndrome. Lesions, as identified by surgery, proved to be accurately predicted by preoperative short segment stimulation in 5 of 6 patients. CONCLUSION: Short segment stimulation studies are helpful in localizing more accurate involved segment in ulnar neuropathy at the elbow. And the most commonly involved site is within 2cm of the medial epicondyle suggesting tardy ulnar nerve palsy.

A Clinical Study of 52 Patients with Myasthenia Gravis Syndrome / 영남의대학술지

The authors experienced 52 patients with myasthenia gravis who were diagnosed at the Department of Neurology, Yeungnam University Hospital from August 1985 to January 1996. The following results were obtained through diagnostic evaluation and treatment. 1. The ratio of male to female was 1:1.7 and the most prevalent age group was second decade. 2. The most common initial presentation symptom was ocular(71.2%) and the peak incidence group was stage I (69.3%) according to the modified Osserman's classification. 3. In 16 patients(30.8%), it took more than a year to diagnose due to symptoms which were relapsed and remitting. 4. Of 52 patients, 2 cases were associated with thyroid disease(3.8%) and 2 with insulin-dependent diabetes mellitus(3.8%). 5. All of those who received anticholinesterase and corticosteroid therapy were improved with the exception of 5 cases which were improved after thymectomy and/or plasmapheresis.

Comparision of Heoatitis B Virus Markers in the Serum and the Cerebrospinal Fluid / 영남의대학술지

We investigated HBV markers in serum and cerebrospinal fluid of 50 subjects with neurologic disorders or other disorders, who visited Dept. of neurology, college of medicine, Yeungnam University, from April-1 to August-31 1994 and were performed cerebrospinal fluid analysis to investigate the detection rate of HBV markers in cerebrospinal fluid and the possibility of neurologic disorders associated with HBV infection. The results were as follows. The positivity of HBsAg and. HBV prevalence rate in serum were 6(12.04) and 37(74.0%). Thf, number of patient with HBsAg, only anti-HBV and no markers were 6(12.0%), 31(62.0%) and 13(26.0%), respectively. The positivity of HBsAg and HBV prevalence rate in cerebrospinal fluid were 3(6%) and 18(36.0%). The number of patient with HBsAg, only anti-HBV and no markers were 6(100.0%), 12(38.7%) and 0(0.0%) respectively. The number of patient with virus associated diseases(VAD) and non virus associated diseases(NVAD) were 26(52%) and 24(48%). The HBV prevalence rate in serum of VAD and NVAD groups were 88.5% and 58.3% (p<0.05). The HBV prevalence rate in CSF of VAD and NVAD groups were 53.8% and 16.7%(p<0.05). The HBV prevalence rate in serum and CSF of VAD and NVAD groups were 60.9% and 28.6%