Genome Sequences of Three Novel Isolates of Human Parainfluenza Virus 2 Associated with Acute Respiratory Infection.

Using target capture of viral nucleic acid and next-generation sequencing, we generated the genome sequences of three novel human parainfluenza virus 2 isolates. Isolates ACRI_0185 (GenBank accession number MF077311), ACRI_0230 (MF077312), and ACRI_0248 (MF077313) were collected in October 2016, February 2017, and March 2017, respectively, from pediatric patients with acute respiratory infection in Arkansas.

Complete Genome Sequence of a Novel WU Polyomavirus Isolate from Arkansas, USA, Associated with Acute Respiratory Infection.

We report here the complete genome sequence of a WU polyomavirus (WUPyV) isolate, also known as human polyomavirus 4, collected in 2016 from a patient in Arkansas with an acute respiratory infection. Isolate hPyV4/USA/AR001/2016 has a double-stranded DNA genome of 5,229 bp in length.

Complete Genome Sequences of Two Novel Isolates of Human Parainfluenza Virus 1 Associated with Acute Respiratory Infection.

Using target capture of viral nucleic acid and next-generation sequencing, we generated the complete genomes of two novel human parainfluenza virus 1 isolates. Isolates AR001 (accession no. KX570602) and NM001 (accession no. KX639498) were collected 3 months apart from pediatric patients with acute respiratory infection from Arkansas and New Mexico, respectively.

Quantitative sensory testing: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

OBJECTIVE: This assessment evaluates the clinical utility, efficacy, and safety of quantitative sensory testing (QST). METHODS: By searching MEDLINE, Current Contents, and their personal files, the authors identified 350 articles. Selected articles utilized computer operated threshold systems, manually operated threshold systems, and electrical threshold devices. The authors evaluated the use of normal values and the degree of reproducibility between the same and different systems. Articles were rated using a standard classification of evidence scheme. RESULTS: Because of differences between systems, normal values from one system cannot be transposed to others. Reproducibility of results was also an important concern, and there is no consensus on how it should be defined. The authors identified no adequately powered class I studies demonstrating the effectiveness of QST in evaluating any particular disorder. A number of class II and III studies demonstrated that QST is probably or possibly useful in identifying small or large fiber sensory abnormalities in patients with diabetic neuropathy, small fiber neuropathies, uremic neuropathies, and demyelinating neuropathy. CONCLUSIONS: QST is a potentially useful tool for measuring sensory impairment for clinical and research studies. However, QST results should not be the sole criteria used to diagnose pathology. Because malingering and other nonorganic factors can influence the test results, QST is not currently useful for the purpose of resolving medicolegal matters. Well-designed studies comparing different QST devices and methodologies are needed and should include patients with abnormalities detected solely by QST.

Preliminary electrophysiological characterization of functionally vestigial muscles of the head: potential for command signaling.

In devastating neurological disorders, such as quadriplegia resulting from high-level spinal cord injury, it is essential to focus on functions that have been spared and optimally exploit them to enhance the individual's quality of life. It follows that certain muscles, which prior to the paralysis of much of the rest of the body seemed to have no useful function, might be used to provide unique signals to control assistive devices. This report presents preliminary electrophysiological data demonstrating potentially useful myoelectrical signals from 3 functionally vestigial muscles in humans; the posterior, anterior, and superior auricular muscles. In phylogenetically lower species, these muscles serve to position the ear to enhance hearing. The auricular muscles receive their major innervation from cranial nerve VII and should not be compromised by even high-level spinal cord lesions. In this study, it was found that the muscles could be voluntarily activated and, by standard surface-electrode recording, had potentials ranging to 680 microV in amplitude. Posterior auricular muscle potentials were used to command a paddle in a computer ping-pong task that employed a CyberLink interface. The t values for accuracy scores and ball hits were both significant at the p = .0001 level. These facts indicate that the auricular muscles may be useful for controlling assistive devices.

Evening primrose oil treatment corrects reduced conduction velocity but not depletion of arachidonic acid in nerve from streptozotocin-induced diabetic rats.

The effects of evening primrose oil (EPO) treatment, a source of gamma-linolenic acid, on the proportions of arachidonoyl-containing molecular species (ACMS) in sciatic nerve phosphatidylcholine and phosphatidylethanolamine were determined in conjunction with alterations in nerve conduction velocity. Normal and diabetic rats were either untreated or fed a dietary supplement containing isocalorically equivalent amounts of either EPO or corn oil for the duration of the experiment. After 8 weeks of streptozotocin-induced diabetes, nerve conduction velocity was reduced 16% and this deficit was prevented by either EPO or corn oil treatment. Neither EPO nor corn oil supplementation significantly increased the depressed proportions of ACMS. The level of the linoleoyl-containing molecular species, 16:0/18:2, was elevated in the phospholipids from untreated diabetic rats and was further increased by EPO treatment. These results are consistent with decreased activity of the delta6 desaturase that is required for arachidonic acid synthesis in vivo, but suggests that an accompanying deficit in the subsequent delta5 desaturase-catalyzed reaction may be rate-limiting. These findings indicate that maintenance of normal ACMS levels is not required for prevention of diminished nerve conduction velocity and suggest that other factors influenced by an altered polyunsaturated fatty acid pattern, such as metabolites of linoleic acid or gamma-linolenic acid other than arachidonic acid, the energy state of the nerve or the degree of membrane fluidity may contribute to impaired nerve conduction velocity in diabetic neuropathy.

Muscle pain, fatigue, and fasiculations.

This article discusses muscle pain, fatigue, and fasiculations. Muscle pain and fatigue are common problems in general medicine and in neurology, while fasiculations raise concern about a potentially ominous disease. The author reviews the conditions that cause pain and similar conditions arising from nonmuscular soft tissues. The article includes a general evaluation to be used for each of these clinical problems.

Acute motor axonal neuropathy in childhood: clinical and MRI findings.

Clinical and radiologic findings in a child with acute motor axonal neuropathy are reported. A 16-year-old boy with mild cerebral palsy presented 1 week after an upper respiratory tract infection with low back pain, ascending weakness, and areflexia. Cerebrospinal fluid (CSF) examination revealed albuminocytological dissociation. Serial electromyograms (EMGs) with nerve conduction velocity (NCV) studies revealed findings of motor axonal neuropathy. Spine MRI revealed enhancement of the cauda equina. Acute motor axonal neuropathy (AMAN) may be an underrecognized cause of acute flaccid paralysis, and to our knowledge no pediatric cases have been reported in the United States. MRI findings have not been reported previously.

The influence of the reference electrode on CMAP configuration: leg nerve observations and an alternative reference site.

Peroneal and tibial compound motor action potentials (CMAP) recorded using the standard belly-tendon montage have different configurations. The peroneal CMAP is a smooth dome shape, while the tibial CMAP has a slow-rising initial component followed by a higher amplitude negative peak. To evaluate possible causes of these differences we investigated the individual activity recordable at the belly and tendon electrodes by using a referential montage with the opposite foot as the reference. This type recording shows that the peroneal belly site produces most of the nerve CMAP, whereas the tendon site generates most of the high tibial CMAP. Some features and technical problems of referential CMAP recording using an opposite limb reference are shown. An alternative method using an ipsilateral distal leg reference site is described. A montage which separately records the activity at the belly or tendon electrodes may provide new insight into mechanisms of commonly observed nerve conduction phenomena.

The influence of the reference electrode on CMAP configuration.

The ulnar, hypothenar compound muscle action potential often shows a double-peaked configuration in the negative phase component while the median, thenar potential has a simple dome shape. To investigate the origin of these differences we evaluated the activity at the belly and tendon electrode locations by referencing those sites to an electrode on the contralateral hand. The tendon sites are not electrically inactive. The ulnar tendon electrode contributes a large amplitude potential which corresponds to the second peak of the ulnar belly-tendon potential. The median tendon electrode contributes only a minimal component to the negative phase of the belly-tendon potential. The distribution of such potentials throughout the hand is evaluated and possible mechanisms for the presence of a tendon potential as well as the differences between ulnar and median sites are discussed.

Schwartz-Jampel syndrome with dominant inheritance.

The Schwartz-Jampel syndrome (SJS) is a rare congenital multisystem disorder of unknown pathogenesis which is characterized by distinct faces, skeletal deformities, joint contractures, short stature, muscle hypertrophy, clinical myotonia, and continuous muscle fiber activity. The inheritance pattern of SJS has been assumed to be autosomal recessive. We report the occurrence of the classic SJS syndrome in both a father and son in a non-consanguineous family, suggesting that SJS has the potential for a dominant pattern of inheritance.

Late-onset familial amyloid polyneuropathy in an American family of English origin.

Recent advances permit biochemical and genetic classification of familial amyloidotic polyneuropathy. We report a family with the methionine-30 prealbumin variant, which is atypical in late age of onset and the appearance of proximal arm weakness before more typical generalized neuropathy.

AAEE minimonograph #31: the electrodiagnosis of ulnar neuropathy at the elbow.

Electrodiagnostic testing is useful in evaluating ulnar nerve elbow lesions. A flexed elbow seems preferable for conduction studies, since it eliminates the elbow segment slowing found in normals done in the extended position. Slowing of the motor velocity in the elbow segment was the most frequent abnormality in this study. Sensory conduction studies and needle examination each provided additional helpful data. Latency to ulnar forearm muscles and "inching" stimulations around the elbow are techniques that also deserve to be included in our standard armamentarium.

A model of the differing change in motor and sensory action potentials over distance.

Clinically recorded motor and sensory nerve responses show different degrees of change in response size over distance along a nerve. We describe a computer model to investigate possible causes of this phenomenon. Effects of the range of conduction velocity in a nerve and the size of the constituent action potentials forming the recorded response are evaluated. We conclude that the broader duration of the motor unit potential is the predominant factor in accounting for motor nerve responses showing less change over distance than sensory responses. The contributions of temporal dispersion and phase cancellation are also discussed.

The evaluation of suspected ulnar neuropathy at the elbow. Normal conduction study values.

Local compression of the ulnar nerve occurs at several points, with the elbow region being the most common. Nerve conduction studies can be useful in identifying and localizing such lesions; however, the specifics of the technique, including normal values, have not been firmly established. We evaluated the effect of elbow position on segmental conduction velocities (CVs), the influence of elbow, nerve segment length on CV calculations, the change in compound action potential amplitude at sites along the nerve, and the use of performing segmental sensory CVs. Conductions done with the elbow flexed produced less segment-to-segment CV variation than those obtained with the elbow extended. The influence of using overlapping nerve segments compared with short adjacent ones for segmental CV comparison is discussed.