Nerve tension mobilization versus active exercises in lumbar radiculopathy

The purpose of this study was to determine the effect of neural mobilization and spinal extension exercises in decreasing pain, hastening neural excitability and increasing, straight leg, raising range in patients with L5-S1 lumbar radiculopathy. Sixty patients with a history of prolapsed disc were involved in the study. Their age ranged from 30-60 years. They were divided randomly into 3 equally groups. Group "1" received neural mobilization, group "2" received spinal extension exercises, and group "3" received both neural mobilization and spinal extension exercises. Pain perception, range of motion of straight leg raise "SLR" and H-reflexi latency of posterior tibial nerve were used as measuring parameters. Results showed that the patients in group "3" got a greatest effect than those in group "1". The patients in group 2 "spinal extension exercises" got the least effect than those in other groups. It was concluded that the cumulative effect of, neural mobilization and spinal extension exercises, is effective to reduce signs of pain and dysfunction for patients with lumbar radiculopathy

Subclinical neuropathy in children with IDDM: peripheral and central nerve functions: part I

Peripheral neuropathy is one of the major complications of diabetes mellitus. However the early natural history of this complication has not been well defined. Studying nerve functions in IDDM at an early stage was the aim of this work in order to evaluate the prevalence of neuropathy. The study included 20 insulin dependent diabetic patients, in addition to 10 healthy subjects of matching age and sex as a control group. Patients were subjected to full clinical evaluation which included detailed survey for neuropathic symptoms and signs, urine testing for microalbuminuria and repeated fasting blood glucose, with measurement of serum glycated hemoglobin [HbA[1c]]. Electrophysiological study included motor conduction studies of the median and deep peroneal nerves and sensory conduction studies of the sural and median nerves in addition to visual evoked potentials [VEPs]. Neuropathic symptoms were present in only 2 patients [10%] but nerve conduction studies revealed the presence of abnormalities in motor and sensory nerve functions which were more common in lower than upper extremities and more in motor nerve functions than sensory nerve functions. The duration of diabetes was a major determinant of the presence of peripheral nerve dysfunction also older age and more height were positively correlated with nerve dysfunction. Central nerve functions testing by visual evoked potentials [VEPs] demonstrated that although eyes of diabetic children showed no abnormalities in fundus examination, the implicit time of the P100 of the VEP, was significantly prolonged in eyes of IDDM cases with duration <5 years while the P100 amplitude was significantly reduced only in IDDM patients with duration of diabetes >10 years. These findings emphasize the importance of follow up and testing for subclinical peripheral and central neuropathy by repeated electrophysiological testing of children with IDDM

Subclinical neuropathy in children with IDDM: autonomic nerve functions: part II

Studying autonomic nerve functions by testing for cardiovascular reflexes in addition to pupillary diameter and adaptation in IDDM at an early stage was the aim of this work in order to evaluate the prevalence of autonomic neuropathy. The study included 20 insulin dependent diabetic patients. In addition to 10 healthy subjects with matching age and sex as a control group. Patients were subjected to full clinical evaluation which included detailed survey for neuropathic symptoms and signs, urine testing for microalbuminuria and repeated fasting blood glucose, with measurement of serum glycated hemoglobin [HbA[1c]]. Autonomic function tests included cardiovascular reflex test, pupil size and measurement of pupillary dark adaptation. There was evidence for autonomic dysfunction demonstrated by abnormal cardiovascular reflexes which was most common in heart rate response to standing which was abnormal in 90% of cases, and also smaller pupil diameter. These findings emphasize the importance of follow up and testing for subclinical autonomic neuropathy in children with IDDM

Biochemical study of children with grand mal epilepsy treated with either carbamazepine or valproate sodium

The present study was conducted on 40 children with grand mal epilepsy attending the Pediatric Neurology Clinic of El-Shatby Children's Hospital [Alexandria]. They were divided into two groups Group [A]: those patients receiving valproate sodium as the sole drug therapy and Group [B]: those patients receiving carbamazepine as the sole drug therapy. Twenty patients from each group were investigated at three stages: Before starting treatment, after four weeks of treatment and after control of the attacks. Twenty healthy, age-matched children were studied as controls. Serum and CSF electrolytes,liver transaminases, alkaline phosphatase and lactic dehydrogenase were studied