Brainstem auditory evoked potentials and middle latency auditory evoked potentials in patients with impaired glucose tolerance.

AIMS: The aim was to investigate the effects of impaired glucose tolerance (IGT) on the central nervous system via brainstem auditory evoked potentials (BAEPs) and middle latency auditory evoked potentials (MLAEPs), and on the peripheral nervous system via nerve conduction studies (NCS). METHODS: Thirty patients with IGT and 20 control subjects underwent NCS, BAEPs and MLAEPs. RESULTS: Tibial distal motor latencies were significantly prolonged in the IGT group; no differences in other parameters, including BAEPs and MLAEPs, were observed between the IGT and control subjects. CONCLUSION: Brainstem involvement may not be seen in IGT patients as in DM. The was no obvious electrophysiological finding indicating peripheral nervous system disfunction in our patients.

Neuromuscular status of thyroid diseases: a prospective clinical and electrodiagnostic study.

With this study, it has been intended to evaluate the neuromuscular symptoms and findings observed in patients with the diagnoses of hyperthyroidism and hypothyroidism. This study included 21 patients with hyperthyroidism, 19 patients with hypothyroidism and a control group comprised of 29 healthy persons. In the patient group with hypothyroidism, the increase in the median motor distal latency and the median sensorial distal latency (p < 0.0001), the reduction in the median sensory action potential amplitude (p < 0.01) and the slowing in the velocity of nerve conduction (p < 0.01) were found significantly different when compared to the control group. H-reflex latencies were determined to be significantly longer bilaterally (p < 0.01). In the patient group with hyperthyroidism, only the reduction in the median sensory action potential amplitude and the prolongation in the distal latency (p < 0.05) were significant. As for the lower extremities, the slowing in the velocity of the nerve conduction of bilateral peroneal (p < 0.0001), the prolongation in the peroneal F-wave latency (p < 0.01), the slowing in the velocity of the nerve conduction of bilateral tibial nerve (p < 0.05), the prolongation in the tibial F-wave latency (p < 0.01), the prolongation in the sural nerve distal latency (p < 0.0001) and the reduction in the sensory action potential amplitude (p < 0.05) were determined to be significantly different compared to the control group. Among the thyroid patients, 17 (42.5%) patients were diagnosed with mononeuropathy and polyneuropathy. Entrapment neuropathy was observed in 30% and diffuse neuropathy in 10% of the patients. Mypopathy findings were observed in 2 patients.

Median sep and blink reflex in thyroid diseases.

Pathological disturbances of thyroid hormones is associated with central and peripheral nervous system disturbances. The aim of this study is to evaluate median nerve stimulated somatosensory evoked potential (SEP) and blink reflex of thyroid patients (hypo and hyperthyroidism). Median SEP was performed in 40 patients (21 with hyperthyroidism and 19 with hypothyroidism). We evaluated the latencies of N9, N11, N13, P9, P11, P14, N20 and P25 waves and the N9-N20, N9-N13, N13-N20 and P14-N20 interpeak latencies. We compared the results of patients with the control group (26 persons). We found that the N20 latency was longer in patients with hyperthyroidism than in the control group and the difference was statistically significant. There was not any statistically significant difference regarding the N9, N11, N13, P9, P11, P14, N20 and P25 latencies and the N9-N20, N9-N13, N13-N20 and P14-N20 interpeak latencies between hypothyroid patients and controls. We performed the blink reflex study in 28 of 40 patients (14 patients with hyperthyroidism and 14 patients with hypothyroidism). Comparing the R1, R2, CR2 (contralateral R2) latencies and durations of the patients and controls, we found that R2 and CR2 duration was shorter in patients with hyperthyroidism. This difference was statistically significant.

Bilateral shoulder fracture dislocations and radiculopathies secondary to electrical injury (a case report).

INTRODUCTION: In this report a case of bilateral shoulder fracture dislocations and C5 radiculopathy developed after an electrical injury is presented. CASE: A 29 year-old male patient referred to our hospital with complaints of inability to raise his hands overhead starting 3 months ago after an electrical injury. The first physical examination revealed loss of strength (3/5) in deltoid muscles bilaterally, bilateral shoulder fracture dislocations and C5 radiculopathies. An open reduction and internal fixation (using K wire, cortical screw) procedure was applied for the right side in the Department of Orthopedics. Postoperatively active (A) and passive (P) ranges of motion (ROMs) were restricted extremely in the right and left shoulder respectively. Since applications of 15 sessions of electrical stimulation for deltoid muscle and physical treatment for both shoulders failed to achieve satisfactory ROMs, K wire extraction was instituted with resultant increase in the right shoulder A/P ROMs after 10 sessions of physical therapy postoperatively. At the last examination which was 18 months after the injury, ROMs of the right shoulder were increased, but not normal. CONCLUSION: It must be remembered that in electrical injury, fractures and dislocations might occur in affected sites without any evidence of trauma with associated neurologic complications, and that these cases must be promptly detected and managed without any delay.

Magnetic resonance imaging in amyotrophic lateral sclerosis.

OBJECTIVE: We aimed to investigate the importance of magnetic resonance imaging for the diagnostic process of the upper motor neuron involvement. MATERIAL AND METHODS: Fifteen patients (Group 1) who were diagnosed with amyotrophic lateral sclerosis in the neurology department of the Sisli Etfal Hospital and 20 controls (Group 2) entered the study. Magnetic resonance imaging examinations were performed in the radiology clinic of the same hospital. T2 and proton density weighted axial images were obtained. These images were evaluated by two blind radiologists. The radiologists looked for two signs: the presence of a low signal intensity at the precentral cortex and the presence of symmetrical rounded foci of high signal intensity within the internal capsule on both T2 and proton density weighted images. RESULTS: For the first sign there was no statistically significant difference between the two groups but for the latter one there was a statistically significant difference. CONCLUSION: We think that the presence of the latter sign may make it possible for the radiologists to help the clinicians further in this difficult and confusing diagnosis.