1/23. Endoscopic supraorbital nerve neurolysis.Endoscopic surgery, performed through small incisions, yields therapeutic results equivalent or superior to those obtained using the conventional approach. The technique has been established in laparoscopic cholecystectomic surgery. In plastic surgery, endoscopic techniques were first developed in aesthetic procedures and have been reported to be useful in face-lift operations, breast reconstruction, muscle flap harvesting and subcutaneous surgery. Endobrow lift has become a more and more popular aesthetic procedure. The endoscope provides an excellent magnification and, through a high power light source, a very good illumination of the operative field. It explains why the endoscope is more and more used in reconstructive procedures. We report the case of a patient suffering from a posttraumatic entrapment of the right supraorbital nerve which was released by an endoscopic approach.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
2/23. Sensory guillain-barre syndrome.OBJECTIVE: To report eight cases of sensory guillain-barre syndrome (GBS). BACKGROUND: The concept of sensory equivalent to ascending paralysis of GBS was raised in 1958, and the diagnostic criteria for a sensory loss and areflexia variant of GBS were proposed in 1981. However, clinical cases meeting these criteria have been relatively scarce. methods: During a 13-year period between 1986 and 1999, the authors collected eight cases of an acute sensory demyelinating neuropathy that met most of the proposed diagnostic criteria of a sensory variant of GBS. RESULTS: In all patients, sensory neuropathy was sudden at onset and peaked to maximal deficit within 4 weeks. In five (63%) cases, there was an antecedent viral illness. All patients had objective sensory loss and diminished or absent reflexes. None showed any muscle weakness. In all four patients in whom the spinal fluid was examined during the first 4 weeks, there was albuminocytologic dissociation. All of the patients had electrophysiologic evidence of demyelination in at least two nerves. Demyelination was demonstrated in motor nerve conduction in seven patients and in sensory nerve conduction in one, indicating that motor nerve conduction studies were the key for the diagnosis of demyelinating neuropathy. All patients had sensory nerve conduction abnormalities in at least one nerve. Three patients responded to immunotherapies. All had a favorable outcome, with a monophasic course of disease and no sign of relapse. CONCLUSION: The current study confirms the existence of sensory GBS.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
3/23. Electrophysiological analysis of pudendal neuropathy following traction.Pudendal neuropathy is an unusual but important complication of orthopedic surgical procedures involving traction on the fracture table. We describe the clinical and electrophysiological features in six patients presenting with perineal sensory disorders and sexual dysfunction following surgical repair of femoral fracture, hip dislocation, or intra-articular foreign body, in which the traction table was used. All underwent electrophysiological recordings: bulbocavernosus muscle electromyography (EMG), measurements of the bulbocavernosus reflex latencies (BCRLs), somatosensory evoked potentials of the pudendal nerve (SEPPNs), sensory conduction velocity of the dorsal nerve of the penis (SCVDNP), and pudendal nerve terminal motor latencies (PNTMLs). Signs of denervation localized to the territory of the pudendal nerve were found in 3 patients, normal BCRL in 6, abnormal SEPPNs in 4, and abnormal SCVDNPs and PNTMLs in all cases. The outcome at 2-year follow-up was good, except in one patient with initially unrecordable PNTML. Perineal electrophysiological examination can thus confirm the pudendal neuropathy and give prognostic information.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
4/23. Monocytoid B cell lymphoma associated with antibodies to myelin-associated glycoprotein and sulphated glucuronyl paragloboside.Monocytoid B cell lymphoma (MBCL) is an immunologically and morphologically well-defined low-grade lymphoma with a predilection for lymph nodes of the parotid region. We describe an association of MBCL with anti-myelin-associated glycoprotein (MAG) polyneuropathy in a 53-year-old male. The diagnosis of stage IV MBCL with nodular bone marrow infiltration, sjogren's syndrome and sensorimotor polyneuropathy was made in October 1996. serum immunoelectrophoresis demonstrated IgMkappa paraprotein. This was then cross-reacted with epitopes of MAG and sulphated glucuronyl paragloboside (SGPG) on myelin sheaths, and detected by thin layer chromatography and Western blot. Direct immunofluorescence of a sural nerve biopsy showed loss of myelin fibres, segmental demyelinization and IgM deposits on the myelin sheaths. The cerebrospinal fluid was normal. After six cycles of chemotherapy (ChlVPP protocol), all the patient's haematological parameters normalized accompanied by an improvement in neurological signs. The improvement of the polyneuropathy after chemotherapy indicates that the autoimmune anti-MAG and anti-SGPG antibodies resulted from the neoplastic lymphoid proliferation.- - - - - - - - - - ranking = 6.9983020718692keywords = fibre (Clic here for more details about this article) |
5/23. Central-peripheral sensory axonopathy in a juvenile case of Alpers-Huttenlocher disease.Peripheral ataxia is reported in a juvenile case of Alpers-Huttenlocher disease (AHD). Neurophysiological and neuropathological investigations revealed a central-peripheral axonopathy, affecting the deep sensation carried by the peripheral nerve fibres and the posterior tracts of the cord, due to neuronal loss of the sensory ganglia. Involvement of the sensory pathways is regarded as a major feature of juvenile AHD.- - - - - - - - - - ranking = 6.9983020718692keywords = fibre (Clic here for more details about this article) |
6/23. BalanceReTrainer: a new standing-balance training apparatus and methods applied to a chronic hemiparetic subject with a neglect syndrome.In this paper we present a mechanical apparatus and methods named BalanceReTrainer for standing-balance training in neurologically impaired individuals. BalanceReTrainer provides an impaired individual with a fall-safe balancing environment, where the balancing efforts of a standing individual are augmented by stabilizing forces acting at the level of pelvis in the sagittal and frontal planes of motion, assisting the balancing activity ankle and hip muscles and at the level of shanks, assisting the knee extensor muscles. A range of different levels of supporting forces is generated by passive, compliant means. Additionally, movement in the sagittal and frontal planes, acquired by transducers is fed to an electronic interface which transforms the current inclinations into a computer mouse signals, which are interfaced to a personal computer (PC) where balance training and evaluation program is running. The level of stiffness support and level of difficulty of computer task can be selected according to current balancing abilities of the impaired individual. We further present results of a case study where an ambulatory chronic hemiparetic subject with neglect syndrome received ten days of balance training on BalanceReTrainer. Biomechanical evaluation of weight-shifting activity before and after treatment shows a substantial functional improvement.- - - - - - - - - - ranking = 2keywords = muscle (Clic here for more details about this article) |
7/23. The silent period in pure sensory neuronopathy."Normal" electromyographic silent periods (SPs), produced by electrical stimulation of digital nerves, were recorded in the voluntarily contracting abductor pollicis brevis (APB) muscle of a patient with pure sensory neuronopathy and absent sensory nerve action potentials (SNAPs). Such findings implicate the smaller, slower conducting fibers in the genesis of the cutaneous silent period. These same fibers may be activated during more proximal stimulation to contribute to the latter portions of the mixed nerve silent period.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
8/23. Restoration of hand function and so called "breathing arm" after intraspinal repair of C5-T1 brachial plexus avulsion injury. Case report.This 9-year-old boy sustained a complete right-sided C5-T1 brachial plexus avulsion injury in a motorcycle accident. He underwent surgery 4 weeks after the accident. The motor-related nerve roots in all parts of the avulsed brachial plexus were reconnected to the spinal cord by reimplantation of peripheral nerve grafts. Recovery in the proximal part of the arm started 8 to 10 months later. Motor function was restored throughout the arm and also in the intrinsic muscles of the hand by 2 years postoperatively. The initial severe excruciating pain, typical after nerve root avulsions, disappeared completely with motor recovery. The authors observed good recruitment of regenerated motor units in all parts of the arm, but there were cocontractions. transcranial magnetic stimulation produced response in all muscles, with prolonged latency and smaller amplitude compared with the intact side. There was inspiration-evoked muscle activity in proximal arm muscles--that is, the so-called "breathing arm" phenomenon. The issues of nerve regeneration after intraspinal reimplantation in a young individual, as well as plasticity and associated pain, are discussed. To the best of the authors' knowledge, the present case demonstrates, for the first time, that spinal cord surgery can restore hand function after a complete brachial plexus avulsion injury.- - - - - - - - - - ranking = 4keywords = muscle (Clic here for more details about this article) |
9/23. Transient facial sensory symptoms following exposure to synthetic pyrethroids: a clinical and electrophysiological assessment.Amongst twenty-three workers exposed to synthetic pyrethroids, ninteen had experienced one or more episodes of abnormal facial sensation, developing between thirty min and three hr after exposure and persisting for thirty min to eight hr. There were no abnormal neurological signs and electrophysiological studies were normal in the arms and legs. It is concluded that the symptoms are most likely to be due to transient lowering of the threshold of sensory nerve fibres or sensory nerve endings following exposure of the facial skin to pyrethroids, similar to the phenomena that have been described following exposure of animal nerves to pyrethroids.- - - - - - - - - - ranking = 6.9983020718692keywords = fibre (Clic here for more details about this article) |
10/23. Disequilibrium after cochlear implantation caused by a perilymph fistula.OBJECTIVES: cochlear implantation has become a safe and effective method for the auditory rehabilitation of the profoundly hearing impaired. incidence of disequilibrium and vertigo after cochlear implantation ranges from 13% to 74% in the literature. Most patients report resolution of these symptoms with medical therapy and vestibular rehabilitation. We present a case of persistent disequilibrium after cochlear implantation. Further workup of this patient revealed radiographic findings suggestive of a perilymphatic fistula, with immediate and complete resolution of symptoms after exploratory tympanotomy and packing around the cochleostomy. STUDY DESIGN: Case report. methods: A retrospective chart review of a patient with postoperative disequilibrium unresponsive to maximal medical and vestibular rehabilitation therapy. RESULTS: Diagnostic workup of the patient included a temporal bone computed tomography (CT) scan, which revealed air in the vestibule and the ampulla of the superior and lateral semicircular canals. After failure of 5 months of conservative therapy, the patient was taken to the operating room for middle ear exploration and repacking of the cochleostomy site. The patient reported immediate and complete resolution of vertigo postoperatively. CONCLUSION: We present a case of disequilibrium as a result of an apparent perilymphatic fistula after cochlear implantation that was refractory to standard therapy. In such cases, appropriate workup should include a temporal bone CT scan to look for air in the vestibule or other abnormalities that may indicate potential etiology. Surprisingly, this patient had immediate and complete resolution of symptoms after surgery. If conservative therapy fails, middle ear exploration by way of an exploratory tympanotomy and packing of the cochleostomy with periosteum and muscle is a viable option and may lead to resolution of symptoms.- - - - - - - - - - ranking = 1keywords = muscle (Clic here for more details about this article) |
| | Next -> |