ABSTRACT
OBJECTIVES: To examine and compare the effects of downwards versus upwards total stripping of great saphenous vein (GSV) on saphenous nerve (SN) injury using clinical and electrophysiological studies. METHODS: Fifty patients with varicosities were equally and randomly assigned to undergo total, upwards stripping (group A) or downwards stripping (group B) of GSV during saphenectomy. SN function was measured with electroneurogram (ENG) before operation, two weeks and 12 weeks after, in order to record the incidence and type of SN injury. Clinical signs of SN injury were also recorded at the same time points. The results were statistically analysed. RESULTS: There were no statistical significant differences on the occurrence of SN injury between groups A and B at two and 12 weeks, respectively, as confirmed with ENG studies and clinical evaluation. There were no differences between the two techniques with regard to the type of SN injury. SN injury was significantly ameliorated from 34% to 6% during the first three months. CONCLUSION: SN injury was equally observed after downwards or upwards total stripping of the GSV, as confirmed by ENG and clinical evaluation, with no differences in injury type. SN injury tends to be relieved through time in most patients.
Subject(s)
Peripheral Nerve Injuries/etiology , Saphenous Vein/innervation , Saphenous Vein/surgery , Varicose Veins/surgery , Vascular Surgical Procedures/adverse effects , Vascular Surgical Procedures/methods , Adult , Electrophysiology , Female , Humans , Incidence , Leg/pathology , Male , Middle Aged , Peripheral Nerve Injuries/physiopathology , Peripheral Nervous System Diseases/etiology , Time Factors , Trauma, Nervous System/etiology , Treatment Outcome , Varicose Veins/complicationsABSTRACT
OBJECTIVES: We present the epidemiological and clinical-laboratory features of Guillain-Barré syndrome (GBS) in northwest Greece over a 9.5-year period. MATERIALS AND METHODS: We studied all the patients with GBS who were admitted to our neurology inpatient service from January 1996 to May 2005 and compared them with previously published series. RESULTS: Forty-six patients were hospitalized during this period. The average crude incidence rate was 1.22/100,000 populations per year, and males were more susceptible than females. There was a spring clustering, as 52.17% presented the syndrome during spring. The axonal type of GBS was recorded in 13.04% of the patients. The most frequent presenting symptom was dysesthetic numbness (52.17%). A large number of patients (56.52%) had up to three times the elevation of liver function values that resolved in a few weeks. Most patients had an excellent recovery and no deaths were recorded. CONCLUSIONS: In our series, there was no difference in the incidence rate and subtypes of GBS but there was a significant seasonality with spring clustering. A transient elevation of transaminases of undetermined etiology was noted in more than a half of our patients. Although seven patients (15.21%) had significant neurologic sequelae, no deaths occurred.
Subject(s)
Guillain-Barre Syndrome/epidemiology , Adolescent , Adult , Age Distribution , Aged , Disability Evaluation , Female , Greece/epidemiology , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/metabolism , Humans , Incidence , Male , Middle Aged , Retrospective Studies , Seasons , Sex DistributionABSTRACT
OBJECTIVE: This paper proposes a novel method for the extraction and classification of individual motor unit action potentials (MUAPs) from intramuscular electromyographic signals. METHODOLOGY: The proposed method automatically detects the number of template MUAP clusters and classifies them into normal, neuropathic or myopathic. It consists of three steps: (i) preprocessing of electromyogram (EMG) recordings, (ii) MUAP detection and clustering and (iii) MUAP classification. RESULTS: The approach has been validated using a dataset of EMG recordings and an annotated collection of MUAPs. The correct identification rate for MUAP clustering is 93, 95 and 92% for normal, myopathic and neuropathic, respectively. Ninety-one percent of the superimposed MUAPs were correctly identified. The obtained accuracy for MUAP classification is about 86%. CONCLUSION: The proposed method, apart from efficient EMG decomposition addresses automatic MUAP classification to neuropathic, myopathic or normal classes directly from raw EMG signals.
Subject(s)
Action Potentials , Diagnosis, Computer-Assisted , Electromyography/methods , Motor Neuron Disease/diagnosis , Muscle, Skeletal/physiology , Signal Processing, Computer-Assisted , Algorithms , Cluster Analysis , Humans , Models, Statistical , Motor Neuron Disease/classification , Motor Neurons/physiology , Muscle, Skeletal/innervation , Pattern Recognition, Automated , Reproducibility of ResultsABSTRACT
This study analyzed the efficacy of an interposed vein conduit graft in eliminating symptoms of painful neuroma of sensory nerves of the hand and preventing recurrence after excising the pathologic tissue and bridging the concomitant gap with the distal nerve segment. Twenty-three patients underwent reconstruction of 25 palmar sensory nerve gaps ranging from 12 mm to 28 mm, as well as 2 dorsal gaps of 32 mm and 35 mm, respectively. Eighteen patients had symptomatic painful neuromas. Subjective and objective evaluation criteria were employed for assessment and were compared with data obtained from primary direct suturing in 25 digital nerves of 21 patients. Electrophysiologic measurements, including sensory nerve action potential and conduction velocity, were similar, with both groups having values significantly lower than normal control values. Two-point discrimination measurements were slightly inferior for the vein conduit-reconstructed nerves compared with results attained after direct suturing. However, neuroma symptoms were eliminated, and in combination with the return of adequate sensibility, all but 1 patient resumed full hand function.
