Nerve conduction study in young children suffering from cerebral palsy

Objectives: Cerebral palsy (CP) is a motor impairment syndrome leading to disorders of movement and posture. Screening of electrophysiological parameters Hoffman reflex (H-reflex and nerve conduction velocities) becomes a necessary for the early detection and management of the disease. The study aimed to assess the various electrophysiological parameters of nerve conduction velocity in CP and age-matched normal children. Matrials and Methods: The present cross-sectional study was performed between children suffering from CP and healthy control. A total of 27 children of 12–24 months of age of either sex were examined. Among them, six children were normal (with age match), seven were diagnosed with spastic CP and remaining 14 children were diagnosed with hypotonic CP The electrophysiological parameters were recorded in the right lower limb (posterior tibial nerve-soleus muscle) of all children. Results: In electrophysiological parameters, H-reflex latency in secs values was significantly decreased in all CP children. The maximum amplitudes of reflexly excitable motor neurons (Hmax) (mV) and Hmax/maximum amplitude of motor response ratio in the gastrocnemius-soleus muscle were significantly increased in spastic CPas compared to control. H-reflex conduction velocity (HRCV) was significantly higher than motor nerve conduction velocity (MNCV) in hypotonic CP children. Conclusion: The electrophysiological parameters were altered in spastic CP children. The electrophysiological parameters in hypotonic CP were within range, indicating they did not suppress the neuronal motor pool. However, HRCV was significantly more than MNCV in hypotonic CP, suggesting some myelination process defect/white matter injury in motor neurons. We concluded that the electrophysiological parameters of the nerve conduction study are a reliable test for the assessment of tone of muscles in children. Thus, it may help in the early initiation of the treatment and therapies in CP children.

Clinical analysis of chronic mild occupational carbon disulfide poisoning / 中国职业医学

Objective: To analyze clinical features and electroneuromyography (ENMG) results of chronic mild occupational carbon disulfide poisoning cases. Methods: A total of 344 patients diagnosed with chronic mild occupational carbon disulfide poisoning based on GBZ 4-2002 Diagnostic Criteria of Occupational Chronic Carbon Disulfide Poisoning were selected as study subjects from 2006 to 2019 using the retrospective study method. Their clinical data was collected and analyzed. Results: The main symptoms of the study subjects were dizziness, headache, insomnia, dreaming, memory impairment, numbness and weakness in the distal extremities. Positive signs mainly included symmetrical glove and stocking distribution like sensory disorders in the distal extremities, and the weakening or absent Achilles tendon reflex and knee reflex. The incidence of symptoms and signs increased with the length of service (all P<0.01). The incidence of fundus and venous changes in patients was 41.3%, which increased with the length of service (P<0.01). ENMG examination showed varying degrees of abnormalities in the peripheral motor and/or sensory nerves in all patients, with a higher incidence of motor nerve abnormalities than sensory nerve abnormalities (21.1% vs 3.7%, P<0.01). The incidence of motor nerve abnormality was higher on the right side than the left side (23.7% vs 18.5%, P<0.01). The incidences of motor nerve abnormalities from high to low in the order were median nerve, common peroneal nerve, ulnar nerve and posterior tibial nerve (34.9% vs 27.9% vs 16.6% vs 5.1%, P<0.01). The incidences of sensory nerve abnormalities from high to low in the order were median nerve, ulnar nerve and sural nerve (5.2% vs 5.1% vs 0.7%, P<0.01). The incidences of left ulnar nerve, right ulnar nerve and right median nerve were higher in male patients than in female patients (15.2% vs 5.3%, 24.0% vs 11.7%, 44.8% vs 28.7%, all P<0.05), while the incidences of the left and right common peroneal nerve in lower extremity motor nerve were lower in male patients than in female patients (18.4% vs 52.1%, 21.2% vs 46.8%, all P<0.01). Conclusion: Chronic mild occupational carbon disulfide poisoning was mainly manifested as multiple peripheral nerve injury. ENMG results showed that the distal motor nerve conduction abnormalities were more sensitive than the sensory nerve conduction abnormalities, with a higher degree of impairment in the upper limb than the lower limb, and more impairment in the right side than the left side.

Nerve Conduction Studies in Asymptomatic HIV Positive Persons

Background: Nerve Conduction Studies were performed in asymptomatic HIV positive persons and corresponding controls to detect subclinical peripheral nervous system involvement in early stage of HIV. Aims & Objective: To perform Nerve Conduction Studies in asymptomatic HIV positive persons and corresponding controls. Material and Methods: In this study,100 participants in the age group 25-45 years were selected. In study group, 50 3 participants who were HIV positive and asymptomatic (CD4 count > 350 cells/mm ) and were not on Anti Retro Viral Treatment (ART), were included. In control group 50 healthy age matched HIV negative participants were included. We performed Nerve Conduction Studies in these participants. For motor nerves, Distal Latency (DL), Motor Nerve Conduction Velocity (MNCV), Compound Muscle Action Potential (CMAP) amplitude were measured and for sensory nerves Onset Latency (OL), Sensory Nerve Conduction Velocity (SNCV) and Sensory Nerve Action Potential (SNAP) amplitude were measured. Results: Nerve Conduction Studies in asymptomatic HIV revealed that, MNCV was significantly decreased for median motor nerve and tibial motor nerve in study group compared to control group, SNAP was significantly reduced for median sensory nerve in study group compared to control group, OL was significantly prolonged for sural nerve in study group than control group and SNCV was significantly decreased for sural nerve in study group than control group. Conclusion: Nerve Conduction Studies in asymptomatic HIV positive persons suggests subclinical peripheral nervous system involvement in early stages of HIV. Hence Nerve Conduction Studies can be important to detect subclinical peripheral nervous system involvement in the early stages of HIV.

Characteristics of peripheral nerve damage caused by occupational acute trimethyltin chloride poisoning / 中国职业医学

OBJECTIVE: To explore the characteristics of peripheral nerve injury caused by occupational acute trimethyltin chloride(TMT) poisoning. METHODS: The clinical manifestations and test data of neurotic electrophysiology, pure tone hearing threshold and acoustic immittance in 16 patients with occupational acute TMT poisoning were retrospectively analyzed. The patients were followed up after 6 months of discharge. RESULTS: Among the 16 cases of occupational acute TMT poisoning, 6, 4 and 6 cases were with mild, moderate and severe poisoning, respectively. For the firstly appeared symptoms, 7 cases had abnormal mental behavior and memory loss, 5 cases had tinnitus and hearing loss, 5 cases had decreased visual acuity, 2 cases had diplopia and 2 cases had binocular pain. The main clinical manifestations included 8 cases of disturbance of consciousness, and 6 cases of abnormal orientation and aggressive behavior. After correction of hypokalemia, 7 cases of patients had limb muscle weakness, hypomyotonia and weakened tendinous reflect, 9 cases had decreased tactile sensation below the groin in the lower limbs, and 6 cases had instability of walking. The main manifestations of neuroelectrophysiological detection were: 9 patients(accounting for 56.3%) showed abnormal neuroelectromyography, 4 cases of severe poisoning had damaged motor nerve, sensory nerve axon and myelin sheath, and the proximal nerve was also partially damaged. There were 2 cases of moderate poisoning showing abnormal symptoms, the axon and myelin sheath of sensory nerve were damaged, one common peroneal nerve was demyelinated. Three cases of mild poisoning had one common peroneal nerve axon damaged, one proximal tibial nerve damaged, and the axon and myelin sheath of sensory nerve were damaged. Brainstem auditory evoked potential I wave and visual evoked potential P100 latency prolonged and amplitude decreased in some of the patients with mild, moderate and severe poisoning. The sensorineural hearing loss occurred in 81.3% of patients. CONCLUSION: Occupational acute TMT poisoning can cause damage to motor nerve, sensory nerve axon and myelin sheath of extremities. Both distal and proximal nerves might be involved. It can also damage cochlear hair cells and optic nerve. Attention should be paid to the early treatment of peripheral nerve damage, cochlear hair cell and optic nerve damage caused by TMT.

The role of motor nerve conduction: in cervical radiculopathy patients

Background: Cervical radiculopathy is the clinical description of when a nerve root in the cervical spine becomes inflamed or damaged, resulting in a change in neurological function. Neurological deficits, such as numbness, altered reflexes, or weakness, may radiate from the neck into the shoulder, arm, hand, or fingers. Patient also complains of tingling, numbness or loss of sensation along with the nerve root dermatome. It is a substantial cause of disability and morbidity, and its cost-effective evaluation and treatment are crucial so there is a definite need to establish a cost effective, reliable, and accurate means for establishing the diagnosis of cervical radiculopathy. Electrodiagnostic tests are the closest to fulfil these criteria out of which nerve conduction tests are one of the electrodiagnostic test.Methods: In this study motor nerve conduction of ulnar and median nerve done in 30 clinically proven cervical radiculopathy patientsResults: There are significant decrease in the conduction velocity of both nerve (median nerve (51.60±7.5), Ulnar nerve (50.60±5.6)) and significantly increased in the mean latency of both nerve (median nerve (6.02±2.4), ulnar nerve (5.8±1.8)).Conclusions: Authors concluded that MNC is the specific test for the diagnosis of cervical radiculopathy. At least the MNC of both nerves included in diagnostic criteria of cervical radiculopathy.

An observational study of ocular motor nerve palsies in diabetes mellitus

Background: Cranial mononeuropathy is a well-documented complication in people with diabetes with almost 7.5-fold increased incidence compared to the non-diabetic population. Cranial nerves III and VI appear to be involved more frequently and spontaneous recovery usually occurs within 3-6 months. Aim of the study: The present study was conducted to assess the pattern of ocular motor nerve palsy in diabetes mellitus, its correlation with glycemic control and other microvascular complications, and to study the recovery pattern. Materials and methods: 51 patients within the age group of 21-70 years with ocular motor nerve palsies who also had T2DM of any duration were included in this study. The patients underwent thorough clinical and ophthalmological examination and lab investigations and were followed up every 2-3 weeks for a period of 6 months to analyze the recovery pattern. Results: The ocular cranial nerve palsies were more common in the 51 to 60 years age group. Overall, males were affected more than females except with third nerve palsy, which showed a slight female preponderance. Sixth nerve involvement was most common and none of the patients had fourth nerve Pushpa Saravanan, R. Saravanan, P. Dharmarajan, I. Periyandavar, Rajesh Kumar Meena, Abhideep S. An observational study of ocular motor nerve palsies in diabetes mellitus. IAIM, 2019; 6(5): 73-79. Page 74 palsy. The left eye was involved more frequently. There was no significant correlation between the level of glycemic control and incidence of ocular motor nerve palsy though retinopathy and nephropathy were seen to occur more with poorer glycemic status. More than three fourth of the patients had complete or partial recovery implying a good prognosis. Conclusion: Ocular cranial nerve palsy, though a common complication of diabetes mellitus, has a good prognosis. Good glycemic control is of paramount importance for earlier and complete recovery.

Effect of red light combined with hot compress on peripheral neuropathy of diabetes / 中国基层医药

Objective To investigate the effect of red light combined with hot compress on diabetic peripheral neuropathy (DPN).Methods From June 2017 to June 2018,110 patients with DPN admitted to the Department of Endocrinology,Hangzhou Hospital of Traditional Chinese Medicine were selected in the study. The patients were divided into study group (55 cases) and control group (55 cases) according to the random number table method.All patients were given DPN basic care and treatment,with red light in the control group,and red light combined with hot compress in the study group.The motor nerve conduction velocity ( MCV) and the sensory nerve conduction velocity (SCV) of the ulnar nerve,median nerve and common peroneal nerve were compared between the two groups before and after treatment.The total scores of the Toronto clinical scoring system ( TCSS) were compared between the two groups before and after treatment.The efficacy of the two groups was compared.Results Before treatment,there were no statistically significant differences in MCV [(40.45 ± 5.33)m/s vs.(40.14 ± 5.08)m/s,t=0.312,P=0.755;(41.15 ± 5.51)m/s vs.(40.86 ± 5.23)m/s,t=0.283,P=0.778;(42.27 ± 5.84)m/s vs.(41.94 ± 5.75)m/s, t=0.299,P=0.766] and SCV [(39.38 ± 4.82) m/s vs.(39.08 ± 4.60) m/s,t=0.334,P=0.739;(40.13 ± 5.45)m/s vs.(39.86 ± 5.15)m/s,t=0.267,P=0.790;(41.18 ± 5.78)m/s vs.(40.89 ± 5.46) m/s,t=0.278, P=0.782] between the ulnar nerve,median nerve and common peroneal nerve in the two groups.After treatment,the ulnar nerve,median nerve and common peroneal nerve of the two groups were treated.The MCV[(48.77 ± 7.25)m/s vs.(44.62 ± 6.30)m/s,t=3.204,P=0.002;(49.35 ± 7.46)m/s vs.(45.36 ± 6.45)m/s,t=3.001,P=0.003;(49.26 ± 7.13)m/s vs.(46.35 ± 6.22)m/s,t=2.281,P=0.025] and SCV[(47.67 ± 6.52)m/s vs.(43.57 ± 5.61)m/s,t=3.535,P=0.001;(47.77 ± 6.63)m/s vs.(44.31 ± 5.14) m/s,t=3.059,P=0.003;(48.33 ± 7.17)m/s vs.(45.12 ± 6.41)m/s,t=2.475,P=0.015] of the two groups were increased,while which of the study group increased more significantly.Before treatment,there was no statistically significant difference in the total scores of TCSS between the two groups [(10.15 ± 1.23) points vs.(10.45 ± 1.51) points,t=1.142,P=0.256].After treatment,the total scores of TCSS decreased in the two groups, while which of the study group decreased more significantly[(7.22 ± 0.85)points vs.(8.15 ± 0.96)points,t=5.379,P=0.000].After treatment,the effective rate of the study group was 87.27%,which of the control group was 63.64%,the difference was statistically significant (χ2 =8.295,P=0.004).Conclusion The combination of red light and hot compress on DPN has a more prominent clinical effect,which is worthy of wide application.

Effect of red light combined with hot compress on peripheral neuropathy of diabetes / 中国基层医药

Objective@#To investigate the effect of red light combined with hot compress on diabetic peripheral neuropathy (DPN).@*Methods@#From June 2017 to June 2018, 110 patients with DPN admitted to the Department of Endocrinology, Hangzhou Hospital of Traditional Chinese Medicine were selected in the study.The patients were divided into study group (55 cases) and control group (55 cases) according to the random number table method.All patients were given DPN basic care and treatment, with red light in the control group, and red light combined with hot compress in the study group.The motor nerve conduction velocity (MCV) and the sensory nerve conduction velocity (SCV) of the ulnar nerve, median nerve and common peroneal nerve were compared between the two groups before and after treatment.The total scores of the Toronto clinical scoring system (TCSS) were compared between the two groups before and after treatment.The efficacy of the two groups was compared.@*Results@#Before treatment, there were no statistically significant differences in MCV [(40.45±5.33)m/s vs.(40.14±5.08)m/s, t=0.312, P=0.755; (41.15±5.51)m/s vs.(40.86±5.23)m/s, t=0.283, P=0.778; (42.27±5.84)m/s vs.(41.94±5.75)m/s, t=0.299, P=0.766] and SCV [(39.38±4.82)m/s vs.(39.08±4.60)m/s, t=0.334, P=0.739; (40.13±5.45)m/s vs.(39.86±5.15)m/s, t=0.267, P=0.790; (41.18±5.78)m/s vs.(40.89±5.46)m/s, t=0.278, P=0.782] between the ulnar nerve, median nerve and common peroneal nerve in the two groups.After treatment, the ulnar nerve, median nerve and common peroneal nerve of the two groups were treated.The MCV[(48.77±7.25)m/s vs.(44.62±6.30)m/s, t=3.204, P=0.002; (49.35±7.46)m/s vs.(45.36±6.45)m/s, t=3.001, P=0.003; (49.26±7.13)m/s vs.(46.35±6.22)m/s, t=2.281, P=0.025] and SCV[(47.67±6.52)m/s vs.(43.57±5.61)m/s, t=3.535, P=0.001; (47.77±6.63)m/s vs.(44.31±5.14)m/s, t=3.059, P=0.003; (48.33±7.17)m/s vs.(45.12±6.41)m/s, t=2.475, P=0.015] of the two groups were increased, while which of the study group increased more significantly.Before treatment, there was no statistically significant difference in the total scores of TCSS between the two groups [(10.15±1.23)points vs.(10.45±1.51)points, t=1.142, P=0.256]. After treatment, the total scores of TCSS decreased in the two groups, while which of the study group decreased more significantly[(7.22±0.85)points vs.(8.15±0.96)points, t=5.379, P=0.000]. After treatment, the effective rate of the study group was 87.27%, which of the control group was 63.64%, the difference was statistically significant(χ2=8.295, P=0.004).@*Conclusion@#The combination of red light and hot compress on DPN has a more prominent clinical effect, which is worthy of wide application.

Effect of electroacupuncture on 1-bromopropane-induced peripheral nerve damage in rats / 中国职业医学

OBJECTIVE: To investigate the therapeutic effect of electroacupuncture on peripheral nerve damage induced by 1-bromopropane( 1-BP) exposure.METHODS: A total of 25 specific pathogen free healthy adult male Wistar rats were randomly divided into blank control group( n = 5),model control group( n = 10),and electroacupuncture treatment( EA) group( n = 10).Rats in the blank control group were not exposed to 1-BP and treated with electroacupuncture.The rats in model control group and EA group were placed in a dynamic inhalation exposure cabinet with 1-BP at concentration of 5 000 mg/m~3.The rats were continuously exposed to 1-BP 8 hours per day,5 days a week,for 4 weeks.At the 3 rd day after the end of the exposure,the EA group was treated with electroacupuncture on“Zu sanli”and“Huantiao”points for 4 courses.Each course included 20 minutes each time,once per day for 7 consecutive days.The body weight,the motor nerve conduction velocity( MCV) and sense nerve conduction velocity( SCV) of sciatic nerves on both posterior limbs of the rats were measured.RESULTS: During the course of 1-BP exposure,the rats in the EA and model control group showed reduction of eating,drinking and activities,limited autonomic activities and their hind limbs dragged.The MCV and SCV of posterior limb sciatic nerve of rats in the model control group were slower than that of the control group at the 4 th,6th and 8th week and the 0 week of the same group( P < 0.05).The MCV and SCV of posterior limb sciatic nerve of rats in the EA group improved with the increase of treatment time( P < 0.05),and those at the 6th and 8th weeks of the experiment( corresponding to the 2nd and 4th week after treatment) were faster than that of the model control group at the same time( P < 0.05).The SCV of the posterior limb sciatic nerve in the EA group recovered to normal level 4 weeks after treatment compared with the blank control group( P < 0.05).CONCLUSION: Electroacupuncture treatment can promote the recovery of peripheral nerve damage in rats with 1-BP poisoning.

Diagnostic value of electrophysiological examinations in infantile spinal muscular atrophy / 临床神经病学杂志

Objective To explore electrophysiological features of infantile spinal muscular atrophy (SMA), and to evaluate diagnostic value of electrophysiological examinations in patients with SMA.Methods Tweenty-seven SMA children from Jan 2011 to Nov 2015 diagnosed in Wuxi People''s Hospital were enralled.All patients had neurogenic changes by EMG and finally confirmed by genetic test as SMA.Basic clinical data were retrospectively analyzed.Nerve conduction velocity was tested in each patient;While EMG was performed in no less than six muscles in each patient.Results All these patients were characterized by progressive flaccid paralysis in limbs.In all cases, amplitude of CMAP in median nerve was significantly decreased, apparent decreased in ulnar nerve and peroneal nerve;while mild decrease of MCV was appeared in ulnar nerve.Nothing abnormal were detected in sensory nerve conduction.EMG demonstrated neurogenic damage.Conclusion Typical clinical symptoms of infantile SMA are progressive symmetrical loss of muscle control and atrophy in limbs, and specificity electrophysiological representation provides very important basis for the diagnosis.

Experimental study on the effect of VIP on MVD in the process of fracture healing in rats with high selectiveneurotomy / 医学研究生学报

Objective The mechanism and signaling mechanisms of fracture healing by vasoactive intestinal peptide (VIP) regulating are not clear.We established an selective cut off sensory/motor nerve combined with tibial fracture rat model to study the effects of VIP and microvessel density(MVD) during the fracture healing process after nerve injury.Methods 60 SD rats were randomly divided into 3 groups: tibial fracture + motor nerve (anterior root) cutting group (group ART);tibial fracture + posterior root (sensory nerve) cutting group (group PRT);tibial fracture group (group SO),and each group were 20.Three groups of rats in the model after the establishment of 1W, 2W, 3W, 4W these time points, were killed.The skeleton specimens were obtained in the vicinity of the fracture 5mm, to observe the expression of VIP and microvessel density of the law of change.Results Histology observation showed: new bone trabecular bone callus maturity of PRT group is lower than SO group and ART group at each time points;the immunohistochemical staining showed that compared with callus VIP average optical density of PRT group at 2w and 3w(0.156±0.015、0.163±0.012), SO group(0.216±0.012、0.223±0.010) and ART group(0.198±0.014、0.212±0.016) increased obviously(P<0.05).The detection of callus MVD indicated that compared with callus MVD average density of PRT group at 2w and 3w(26.4±2.2、32.3±2.0), SO group(38.2±2.3、40.6±2.6) and ART group(36.6±2.2、38.5±2.1) significant increased (P<0.05).At the 2nd, 3rd and 4th week, the wet weight of tibia was significantly increased in group ART and SO compared with group PRT(P<0.05),which increased more significantly at 2 weeks.Conclusion The effect of loss of sensory nerve innervation on the formation of microvessel density, callus maturity and fracture healing rate were more pronounced than loss of motor nerve innervation.

Comparative Assessment of Motor Nerve Conduction Velocity among Non-Diabetic, Diabetic Non-Smoker and Sub Groups of Diabetic Smoker.

Background: Neuropathy is one of the most common complications affecting individuals with diabetes mellitus. The best evidence indicates that the etiology of neuropathy is multifactorial and is a key area of current research. Hence, this study was undertaken to test the hypothesis of alteration in MNCV (motor nerve conduction velocity) of nerves before the actual manifestation of neuropathy in type II diabetic patients and also to analyze the effect of smoking on MNCV in diabetic subjects. Methods: In the present study, 120 diagnosed diabetics were taken as cases while 30 non diabetic healthy subjects were taken as controls. Case group was divided into diabetic non-smokers and diabetic smokers. Diabetic smokers were further subdivided into light, moderate and heavy smokers, according to smoking index. After detailed history and physical examination MNCV of median and ulnar nerve in upper limb and common peroneal nerve in lower limb was performed. Result: The MNCV of median and ulnar nerves in upper limb showed no significant bilateral decreased in diabetic non-smokers and subgroup of diabetic smokers when compared with control. However, there was a significant bilateral decrease in MNCV of common peroneal nerves in the lower limb of diabetic heavy smokers when compared with control. A negative, but statistically non-significant correlation was found between MNCV and smoking index. The decrease in MNCV was dependent on smoking index by 3%, 1%, 1%, 1%, 3% and 1% in median nerve (right), median nerve (left), ulnar nerve (right), ulnar nerve (left), common peroneal nerve (right) and common peroneal nerve (left) respectively. Conclusion: The present study indicates that MNCV is more resistant to hyperglycemia induced local metabolic and microvascular changes. However, the coalition of diabetes and smoking can augment their effects many folds and can lead to motor neuropathy, reiterating the fact that smoking itself is an independent risk factor for diabetic neuropathy.

Motor-Unit Number Estimation Is Sensitive in Detecting Motor Nerve Involvement in Patients with Carpal Tunnel Syndrome

BACKGROUND AND PURPOSE: We compared the motor-unit number estimation (MUNE) findings in patients who presented with signs and/or findings associated with carpal tunnel syndrome (CTS) and healthy controls, with the aim of determining if motor-unit loss occurs during the clinically silent period and if there is a correlation between clinical and MUNE findings in CTS patients. METHODS: The study investigated 60 hands of 35 patients with clinical CTS and 60 hands of 34 healthy controls. Routine median and ulnar nerve conduction studies and MUNE analysis according to the multipoint stimulation method were performed. RESULTS: The most common electrophysiological abnormality was reduced conduction velocity in the median sensory nerve (100% of the hands). The MUNE value was significantly lower for the patient group than for the control group (p=0.0001). ROC analysis showed that a MUNE value of 121 was the optimal cutoff for differentiating between patients and controls, with a sensitivity of 63.3% and a specificity of 68.3%. MUNE values were lower in patients with complaints of numbness, pain, and weakness in the median nerve territory (p<0.05, for all comparisons), and lower in patients with hypoesthesia than in patients with normal neurological findings (p=0.023). CONCLUSIONS: The MUNE technique is sensitive in detecting motor nerve involvement in CTS patients who present with sensorial findings, and it may be useful in detecting the loss of motor units during the early stages of CTS. Larger-scale prospective clinical trials assessing the effect of early intervention on the outcome of these patients would help in confirming the possible benefit of detecting subclinical motor-unit loss in CTS.

Therapeutic effect of the combined treatment of mecobalamin and salvia miltiorrhiza ligustrazine on diabetic peripheral neuropathy / 中国基层医药

Objective To learn therapeutic effect of the combined treatment of mecobalamin and salvia milti-orrhiza ligustrazine on diabetic peripheral neuropathy.To provide effective and reliable operation method for the treat-ment of disease.Methods 163 cases with diabetic peripheral neuropathy were randomly divided into observation group(86 cases)and control group(77 cases).The observation group was treated with mecobalamin combined salvia miltiorrhiza ligustrazine,the control group was treated with mecobalamin.The sensory conduction velocity (SNCV) and motor conduction velocity (MNCV)were measured in the two groups before and after treatment.The therapeutic effects were evaluated after one course.Results The MNCV and SNCV of the two groups were higher than before treatment,the difference was statistically significant (t =24.298,25.546,18.737,15.733,14.284,14.886,9.337, 9.402,all P 0.05).Conclusion In the treatment of diabetic peripheral neuropathy,the com-bined treatment of mecobalamin and salvia miltiorrhiza ligustrazine has better curative effect and low incidence rate of adverse reaction,with good clinical application value.

Clinical Observation of Foot Bath Treatment by Tangkang Xifang in Patients with Type 0 Diabetes Foot / 中国药师

Objective:To observe the clinical treatment effects of Tangkang Xifang in the patients with type 0 diabetes foot ( DF) . Methods:Totally 73 patients with type 0 DF were randomly divided into the treatment group (n=37) and the control group (n=36). All the patients discontinued other medications for 7d before the treatment. Base on the blood glucose control with the traditional treat-ment by metformin hydrochloride (1. 5 g·d-1), the treatment group was additionally given warm water foot bath with Tangkang Xi-fang, while the control group was additionally given warm water foot bath, 30 min per time and twice a day for 60 days. The changes in the clinical symptoms, ankle brachial index ( ABI) , motor nerve conduction velocity ( MCV) and some other indices were measured before and after the treatment. Results:In comparison with the control group (58. 3%), the treatment group had higher total effective rate (86. 5%), and the usage of Tangkang Xifang also significantly improved the physiopathologic syndromes of peripheral artery dis-ease and neuropathy (P<0. 01). The ABI and MCV in the treatment group were significantly better than those in the control group (P<0. 05 or P<0. 01). Conclusion:Tangkang Xifang can effectively improve the clinical symptoms of type 0 DF, which is suitable for the clinical application.

Electrophysiological changes in acute guillain-barre syndrome.

Aim: To study the various electrophysiological changes in the motor conduction, sensory conduction and F wave latencies of acute Guillain-Barre Syndrome patients. Methods: Sixteen patients with acute GBS were included in this study. They were subjected to various nerve conduction studies (NCS) following standardized procedures. The mean values obtained for the various nerve conduction parameters were compared against the corresponding standardized values using Student’s t-test. P value less that 0.05 was considered significant. Results: The results of NCS in GBS patients were as follows: 1.The motor nerve conduction velocity was significantly lower and the motor nerve conduction latency was significantly prolonged. 2. The sensory nerve action potential conduction velocity and amplitude remained normal in most of these individuals. 3. F wave latency was significantly prolonged. Conclusion: Acute Guillain-Barre Syndrome patients manifest with abnormal motor nerve conduction parameters and F wave latency. Electrophysiological studies would help the researchers to diagnose the disease at an early stage.

The neurophysiological changes associated with pulmonary function in patients with obstructive sleep apnea syndrome / 中华物理医学与康复杂志

Objective To observe neurophysiological changes and pulmonary function in obstructive sleep apnea syndrome (OSAS) and analyze their inter-relationship. Methods Sixty OSAS patients were studied. Their lung function and phrenic motor nerve conduction (PNC) were examined. Thirty cases without respiratory disorder served as controls. The lung function tests included percentage of the predicted value of vital capacity ( VC% ), percentage of the predicted value of maximal voluntary ventilation ( MVV% ), percentage of the predicted value of forced expiratory volume in one second ( FEV1% ), inspiratory capacity ( IC), and expiratory reserve volume (ERV). The phrenic nerve was stimulated electrically, and the latent period and the diaphragmatic compound muscle action potential (dCMAP) were recorded. Results The VC%, MVV%, FEV1% , IC and ERV of the patients with OSAS were significantly lower than those of the controls. There was no significant difference between the patients and the controls with regard to their PNC latency. In the OSAS patients the amplitude ratio of their dCMAPs was positively correlated with VC% , MVV% , FEV1% , IC and ERV, and negatively with an apnea hypopnea index (AHI).Conclusions PNC examination can provide valuable information for evaluating diaphragmatic dysfunction in those with abnormal lung function. Decreased dCMAP might be associated with abnormal lung function.

Clinical features and electrophysiology analysis of 13 cases of infantile spinal muscular atrophy / 上海交通大学学报（医学版）

Objective To investigate the clinical and electrophysiology features of infantile spinal muscular atrophy,and explore the clinical significance of genetic diagnosis. Methods The clinical data of 13 infants suffering from infantile spinal muscular atrophy were analysed.The serum creatine phosphokinase was examined,and nerve conduction velocity was tested in median nerve,ulnar nerve,tibial nerve and peroneal nerve.The parameters such as distal motor latency,motor nerve conduction velocity and amplitude of compound motor active potential were analysed.Electromyography was performed in no less than four muscles,and the insertion potential,spontaneous potential and motor unit action potential were observed.Deletion of exon 7 in SMN1 gene was detected by polymerase chain reaction-restriction fragment length polymorphism(PCR-RFLP). Results All these infants were characterized by progressive flaccid paralysis in limbs.In all cases,amplitude of muscle response was significantly decreased,with prolonged distal latency and slowed conduction velocity.Electromyography demonstrated motoneuron degeneration.Deletion of exon 7 in SMN1 gene was detected in all 13 infants. Conclusion There are unique clinical and electrophysiology features for infantile spinal muscular atrophy,and electromyography may play an important role in the diagnosis.Prenatal genetic diagnosis may help to avoid the birth of this kind of infants.

Establishment of normative value of multiple segments motor nerve conduction velocity of bilateral median nerve and ulnar nerve / 中国康复医学杂志

Objective: To establish normative value of multiple segments motor nerve conduction of bilateral median nerve and ulnar nerve, including motor nerve conduction velocity (MCV)、latency (LAT)and amplitude (AMP). Method: Two hundred normal volunteers were divided into 5 groups according to different ages. Median nerve was examined at multiple points: palm, wrist, elbow, axilla and Erb's. Ulnar nerve was examined at multiple points: wrist, below elbow, above elbow, axilla and Erb's. The values of segmental MCV, LAT and AMP were recorded. Result: Gender and sidedness had no effect on MCV, LAT and AMP of median nerve and ulnar nerve. However, age had significant effects on MCV, LAT and AMP of median nerve and AMP of ulnar nerve. Conclusion: The examination of multiple segments motor nerve conduction of bilateral median nerve and ulnar nerve possess important value in diagnosis.

Hypothyroid associated polyneuropathy in dogs: report of six cases / Polineuropatia associada a hipotireoidismo em cães: relato de seis casos

Six Doberman Pinscher, between six and eight years of age, were presented to the Veterinary Hospital from Faculty of Veterinary Science of The University of Buenos Aires. Neurological examination revealed tetraparesis with inability to walk, decreased muscle tonus and myotatic reflexes in all dogs. Serum cholesterol levels, creatine kinase and alkaline phosphatase activities were mildly to markedly elevated, and tibial motor nerve conduction velocities were slow in all dogs. Basal measurements of free T4 and TSH were determined by radioimmunoassay. Although fT4 values were within normal range, in all dogs TSH values were elevated. Based on this results, hypothyroidism was diagnosed and a supplementation therapy was established with oral levothyroxine (T4). Two weeks after treatment has been started, all patients had an improvement in clinical signs, and within a month gait became normal, as well as muscular tonus and spinal reflexes.

Seis Dobermans Pinscher, entre seis e oito anos de idade, foram encaminhados ao Hospital Veterinário da Faculdade de Ciências Veterinárias da Universidade de Buenos Aires. O exame neurológico revelou tetraparesia com incapacidade para andar, diminuição do tono muscular e de reflexos miotáticos em todos os cães. Os níveis de colesterol, creatina quinase e fosfatase alcalina encontravam-se de moderada a acentuadamente elevados. As velocidades de condução nervosa do nervo tibial estavam diminuídas em todos os cães. Os níveis séricos basais de T4 livre e TSH foram determinados por radioimunoensaio e, embora os valores de T4 livre estivessem dentro dos limites de normalidade, em todos os cães o TSH estava elevado. Baseado nestes resultados, diagnosticou-se hipotireoidismo e iniciou-se uma suplementação oral com levotiroxina (T4). Duas semanas após o início do tratamento todos os pacientes tiveram melhora clínica e, dentro de um mês a locomoção, o tono muscular e os reflexos medulares tornaram-se normais.