study of retrograde degeneration of median nerve, forearm segment in carpal tunnel syndrome of variable seventies

Carpal tunnel syndrome [CTS] is a disorder of the hand which results from compression of the median nerve within its fibro-osseous tunnel at the wrist. The slowing in the forearm motor conduction velocity suggests the presence of retrograde degeneration. Existing studies conflict regarding a correlation between the seventies of the entrapment neuropathy in CTS and slowing of median motor nerve conduction velocity in the forearm. The objective of this work was to study retrograde degeneration [RGD] of the median nerve forearm segment in patients with CTS and its relation to variable severity of CTS in Egyptian patients. Twenty-four patients with CTS were included in this study. The Forearm mixed nerve conduction is presumed to be indicative of the conduction of the median nerve over the forearm and is used widely to assess causes of slowing forearm conduction velocity in CTS. In addition to conventional nerve conduction studies of the upper limb, forearm median mixed conduction studies were performed Median motor forearm amplitudes and nerve

Postural control and central motor pathway involvement in type 2 diabetes mellitus: dynamic posturographic and electrophysiologic studies

Postural instability causes limitations in daily activities of diabetic patients. There is paucity of data regarding central motor pathway involvement in these patients and its relation to postural control. To evaluate postural control and central motor pathway involvement in type 2 diabetic patients. The study included 30 type 2 diabetic patients and 15 healthy, age and sex matched control subjects. Both groups were subjected to physical and full neurological examination, in addition to electrophysiological study including peripheral conduction study and MEPs recorded from the feet muscles. Total neuropathy score was calculated. In addition, dynamic posturographic tests were performed including sensory organization test and MCT. Most of the dynamic posturographic parameters were significantly impaired in diabetic patient group. There were significant abnormalities in most of the parameters of the peripheral conduction study of the patients compared to the controls. According to the Total neuropathy score, 20 patients had peripheral neuropathy. In addition, there was significant prolongation of the left CMCT, decreased left MEP amplitude and increased MEP resting motor threshold on both sides in the patients compared to the control group. Dynamic posturographic parameters showed correlation with most of the parameters of the peripheral conduction study and few of the MEP parameters. Logistic regression analysis showed peripheral neuropathy as the main factor implicated in postural instability in these patients. However, significant correlation was found between MEP amplitude and MCT composite score in patients without peripheral neuropathy. Although type 2 diabetic patients had prolonged CMCT, decreased amplitude and increased resting motor threshold of the MEP response, peripheral neuropathy was the main factor implicated in postural instability. However, the central motor pathway changes documented could be implicated as a possible cause