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Objective To analyze the clinical characteristics and prognosis of neurobrucellosis(NB).Methods Twenty-seven cases of NB patients who received treatment in Disease Prevention and Control Center of Inner Mongolia Autonomous Region and Inner Mongolia Medical University Hospital from January to December in 2016 were collected.The clinical data of these patients were recorded and systematically analyzed.Results Twenty-four cases(88.89%)had a history of exposure to cattle and sheep.Twenty-four cases(88.89%)were admitted with fever,18(66.67%)cases with sweat,16 cases(59.26%)with headache,14 cases(51.85%)with neurological symptoms of meningitis and meningoencephalitis,4 cases(14.81%)with auditory nerve damage and 3 cases(11.11%)with spinal cord damage.Elevated white blood cells were found in 2 cases(7.41%),elevated serum C-reactive protein in 3 cases(11.11%),elevated procalcitonin in 2 cases(7.41%)and elevated erythrocyte sedimentation rate in 15 cases(55.56%).All the 27 patients underwent lumbar puncture and the cerebrospinal fluid test results were abnormal,of which increased protein levels in 17 cases(62.96%),increased mononuclear cell ratio 14 cases(51.85%),increased pressure in 14 cases(51.85%),and reduced chloride levels in 14 cases(51.85%),and reduced glucose levels in 6 cases(22.22%).Positive cerebrospinal fluid culture(CSF)was found in 1 case(3.70%).There were 8 cases(29.63%)with white matter damage,5 cases(18.52%)with meningeal enhancement,3 cases(11.11%)with spinal cord lesions,2 cases(7.41%)with cerebral edema and 2 cases(7.41%)with brain abscess.There were 10 cases(37.04%)with sensory nerve damage in the extremities,4 cases(14.81%)with auditory nerve damage and 2 cases(7.41%)with motor nerve damage.All patients were treated with regular anti-Berg's disease for 6 weeks and were followed up for 1 year(every 3 months)after the treatment.Nineteen patients(70.37%)were cured,7 patients(25.93%)developed sequelae and 1(3.70%)patient died.Conclusions The analysis suggests that NB have a variety of clinical characteristics.CSF examination,imaging examination and neuro electrophysiology detection have contribution to the diagnosis of the NB.
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Objective To study the neuro electrophysiological characteristics of paraneoplastic peripheral neuropathy (PPN) . Methods A retrospective study was conducted for 29 PPN patients consecutively referred to Neurology Department of the First Affiliated Hospital of Kunming Medical University between January 2000 and June 2017. The electrophysiological characteristics of motor nerves, sensory nerves of upper and lower limbs were analyzed. Measurement indicators include: (1) The motor conduction velocity and compound muscle action potential amplitude of median, ulnar, tibial, and common peroneal nerves; (2) The sensory conduction velocity and sensory nerve action potential amplitude of median, ulnar, tibial, and superficial peroneal nerves;(3) F waves of median and tibial nerves.Results (1) For patients with PPN, their motor and sensory nerves in upper and lower limbs were damaged. The total anomaly rate of the amplitude was higher than that of the nerve conduction velocity (P＜0.05), while the abnormal rate of amplitude of sensory nerve action potential was greater than that of motor nerve compound muscle action potential (P＜0.05) . Abnormal motor nerve conduction velocity had a similar incidence to abnormal sensory nerve conduction velocity (P＞0.05) . (2) Nerve conduction study showed that abnormality rate of lower extremity is higher than that of upper extremity. (3) Abnormal F waves were observed less frequently than abnormal nerve conduction rates (P＜0.05) . Conclusions The electrophysiological properties of PPN were frequently seen in sensorimotor neuropathy. The damage of distal extremities is more serious. The damage in lower extremity is more severe than that in the upper extremity. The axonal damage mainly occurred in sensory nerves. There is no obvious difference in the degree of demyelination between motor and sensory nerves. Evidence can be provided by analyzing the neuro ectrophysiological characteristics for diagnosis of paraneoplastic peripheral neuropathy in early stage.
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Objective The change of thyroid hormones affects male sexual function, but the underlying physiological mechanism is not yet clear.The aim of this study was to explore the association of thyroid hormones with abnormal penile neuro-electrophysiology in patients with premature ejaculation (PE).Methods This retrospective study included 52 acquired PE (APE) patients aged 35.36 ± 8.39 years and 24 healthy males aged 32.87±7.45 years.We measured the levels of thyroid hormones in all the subjects and, based on the latency time of penile sympathetic skin responses (PSSR), classified the APE patients into a normal (n=31) and an abnormal PSSR type (n=31).Results The concentration of total tetraiodothyronine (TT4) in the serum was significantly higher in the APE patients than in the normal control ([102.81±18.37] vs [92.68±11.56] nmol/L, P=0.018).The levels of serum TT4 and free tetraiodothyronine (FT4) were both markedly increased in the APE patients of the abnormal PSSR type as compared with those of the normal PSSR type ([113.28±20.89] vs [95.72±12.42] nmol/L, P<0.001 and [12.02±0.88] vs [10.81±1.63] nmol/L, P=0.003).The FT4 concentration was correlated negatively with the latency time of PSSR (r=-0.363, P=0.008) and positively with the Premature Ejaculation Diagnostic Tool (PEDT) scores (r=0.455, P=0.001).Conclusion Abnormal PSSR may be associated with elevated levels of thyroid hormones in APE patients, and regulation of thyroid hormone levels may help improve the symptoms of PE with abnormal PSSR.
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In recent decades, the development of the neurosurgery has changed from the traditional anatomical model to the modern anatomical-functional model. The nerve functions are maximally protected while lesions are removed as far as possible. Neurophysiological monitoring especially somatosensory evoked potentials (SEPs) and motor evoked potentials (MEPs) can directly reflect the integrity of the sensory and motor nerve conduction pathways of the nervous system. At present, it has been widely used in the neurosurgery, spinal surgery, vascular surgery and other surgical fields. In recent years, more and more clinical surgeries involved spinal surgery, intraoperative neurophysiological monitoring could timely find any reversible spinal cord damage such as mechanical stretch, ischemia, and anesthetic drugs, which not only improve the quality of surgery, reduce iatrogenic spinal cord injury, but also greatly improve the prognosis of patients and reduce postoperative neurological dysfunction and complications. In this paper, the research progress of neural electrophysiological monitoring techniques in spinal cord surgery is reviewed.
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In recent years, neuro-electrophysiological techniques, as objective evaluation methods, have been gradually used in func-tional evaluation, guiding clinical rehabilitation programs and judging prognosis after stroke. They were proved to judge the integrity of cen-tral nervous system and conduction function and evaluate neuromuscular function. Nerve conduction, needle electromyography, H reflex, F wave, sympathetic skin response, motor-evoked potentials, somatosensory-evoked potentials, brain stem auditory-evoked potentials and sur-face electromyography were reviewed in this article.
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Objective To study the clinic, neuro electrophysiology and molecular biology of Machado Joseph disease (MJD).Methods Family visiting, physical examination and the blood samples were analysed on molecular biology in 44 members of a family with MJD.The cases of inpatients were examined on cerebrospinal fluid and neuro electrophysiology.Results 10 patients of the family attacked,which were consisted with autosomal dominant inheritance type. Age of the onset was 8~38 years old. The clinical characteristic was progressive severe spinocerebellar of ataxia,faciolingual myokymia,bulging eyes.Change of denervated muscle was revealed by neuro etectrophysiological examination. Light atrophy was observed in cerebellar,brain stem, spinal cord.The genetic defect of MJD was located the long arm of chromosome 14 between D 14 S 280 and D 14 S 81 , their distance was 3.0 cm.All tested patients had their CAG repeated expansion from 72 to 84 in the MJD gene.Conclusion MJD is a neuro degenerative disorder of autosomal dominant inheritance. The disease was clinically characterized by progressive severe spinocerebellar ataxia, no obvious changes of cerebrospinal fluid,neuro electrophysiology, CT and MRI.The genetic defect of MJD was located the long arm of chromosome 14.The number of CAG repeated expansion mutation was associated with the age of the onset.
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ObjectiveTo explore the relationship between the changes of neuro-electrophysiology and prognosis in children with Guillain-Barr? syndrome(GBS).MethodsThirty-eight children with GBS were divided into group A(rapid recovery,n=16) and group B(slow recovery,n=22) according to the time required for podosoma motor function recovery,at the same time,they were divided into the better prognosis group(n=22) and the worse prognosis group(n=16),for analyzing the difference between group A and B in terms of age,preceding infections,maximal Hughes grades and neuro-electrophysiology including motor conduction velocity(MCV),distal complex muscle action potential(dCMAP) and F wave,and investigating the related factors with the prognosis of GBS.Results1.MCV of tibial nerve was(40.2?2.53) m/s and(33.4?2.46) m/s in group A and group B,respectively;MCV of peroneal nerve was(45.2?3.23) m/s and(38.3?2.16) m/s in group A and group B,respectively,and the difference between group A and group B was significant(Pa0.05);abnormal rate of F wave(68.42%) was higher than abnormal rate of MCV(42.11%) and dCMAP(42.11%)(Pa