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Objective:To explore the application value of microsurgical tethered cord release in children with tethered cord syndrome under perioperative electro-neurophysiology monitoring.Methods:Ninety-six patients with tethered cord syndrome accepted tethered cord release in our hospital from January 2015 to December 2019 were chosen in our study; perioperative electro-neurophysiology monitoring was performed to evaluate whether there was neurological impairment. The surgical results, neuroelectrophysiological monitoring results, and follow-up results were retrospectively analyzed.Results:In these 96 patients, symptoms disappeared in 45 patients, improved in 34, not improved in 10, worsened in 3, and tethered again in 4 patients, with a total effective rate of 82.6%. No death was noted. Preoperative neuroelectrophysiological monitoring showed abnormal sensory and motor functions of lower limbs in 40 patients, and postoperative monitoring showed abnormal sensory and motor functions of lower limbs in 6 patients. Follow up was performed for an average of 13 months; symptoms improved in 79 patients, stabilized in 10 patients, and aggravated in 7 patients.Conclusion:In children with tethered cord syndrome, tethered cord release should be performed as soon as possible regardless of early neurological injury; perioperative electro-neurophysiology monitoring can protect spinal cord function, prevent nerve function injury, improve the surgical safety and improve the prognosis of these children.
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Objective To research the pathogeny and the electromyographic characteristics of myokymia.Methods The clinical features and electromyography of 42 elderly patients with myokymia were examined. Results Symptomatic myokymia (SM) in 27 cases was caused by low salt syndrome, thyrotoxemia, urinaemia, chronic wasting diseases (such as carcinoma of the stomach or liver), brachial plexus neuropathy, lead poisoning, chronic inflammatory demyelinating polyradiculoneuritis, succinylcholine narcosis, restless leg syndrome or Isaac's syndrome.Symptomatic facial myokymia was caused by neoplasm of the brain stem or in posterior cranial fossa, multiple sclerosis or other causes. Primary myokymia ( PM ) in 15 cases involved idiopathic generalized and benign myokymia.Compared with PM, SM was more constant and powerful. Myokymia potential appeared in the electromyograms of 42 of the patients. The majority of patients with SM had accompanying myotonic discharge. Conclusion The pathogeny and electromyographic characteristics of symptomatic myokymia are different from the primary stage.
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Objective To explore the clinical significance of EEG and CT presentations in the patients with acute ischemic stroke. Methods Fifty-six consecutive patients with acute ischemic stroke admitted immediately after the onset were enrolled in this study.Thefindings bYCT,EEG,brain electrical activity mapping(BEAM),examinations of somatosensory evoked potentials(SEPs)and motor evoked potentials(MEPs)to transcranial magnetic stimulation, and the scores of modified Edinburgh-Scandinavia stroke scale(MESSS)and Barthel Index(BI)were comparatively analyzed in these patients. Results The location of the cerebral foci with EEG abnormalities were basically consistent with the lesions indentified by CT.but the range of the lesions defined by the two modalities showed some discrepancies.There Was statistically significant difference in SEP and MEP between the injured and uninjured sides(P<0.05).There was apositive correlation between MESSS on admission and BI on day 28 in hospital(r=0.58,P<0.05). Conclusion CT and cerebral electrophysiological examination provide valuable assistance in early diagnosis of acute ischemic stroke.
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Objective To study the clinical and electrophysiological characteristics of peripheral neuropathy in patients with multiple sclerosis(MS).Methods As a total of 84 MS patients,the clinical and electrophysiological data were analyzed in 16 MS patients with the symptoms of peripheral neuropathy(PNMS group)and in 68 MS patients without peripheral neuropathy(NPNMS group).Results The incidence of peripheral neuropathy was 19.0%(16/84)in this group.The clinical symptoms included extremity numbness in 14 cases(87.5%),limb inertia in 12 cases(75.0%),and radicular pain in 4 cases(25.0%).Signs included decrease of tendon reflex in 15 cases(93.7%),periphery sensory disability in 13 cases(81.2%),and myatrophy in 5 cases(31.2%).The mean age in the PNMS group was(44.6?12.5)years vs.(32.2?11.5)years in the NPNMS group.The course of disease was(39.3?18.3)months vs.(31.6?17.2)months in the NPNMS group,there were significant differences in two groups(P