No abstract available.
Neural Conduction*

No abstract available.

OBJECT: The isolated posterior femoral cutaneous nerve (PFCN) neuropathy has rarely been described in the literature and documented electrophysiologically, based on the paucity of published report. The purpose of this study was to assess the reference value of somatosensory evoked potentials (SSEP) in posterior femoral cutaneous nerve. METHOD: Both legs of twenty healthy adults were tested. Somatosensory evoked potentials were obtained with the active recording electrode placed at Cz', 2 cm posterior to CZ, and the reference electrode at FZ (international 10~20 system). The posterior femoral cutaneous nerve was excited 14 cm proximal to the midpopliteal fossa between the long head of the biceps femoris and the semitendinosus muscles. RESULTS: The mean latency of right P1 were 35.35+/-3.17 msec, N1 were 45.28+/-2.71 msec and mean peak amplitudes were 1.42+/-0.98 microvolt. In the left side, mean latency of P1 were 34.54+/-2.89 msec, N1 were 43.87+/-2.44 msec and mean peak amplitudes were 1.20+/-0.53 microvolt. CONCLUSION: Based on the result of this study, the reference values could be used to differentiate and detect the lesion in the case of isolated dysfunction of the posterior femoral cutaneous nerve.
Adult* ; Electrodes ; Evoked Potentials, Somatosensory* ; Head ; Humans ; Leg ; Muscles ; Reference Values

The study of blink reflexes was carried out to demonstrate the correlations, if there were, between the stage of diffuse axonal injury(DAI) and the abnormality of blink reflexes. The blink reflex was recorded in 20 healthy adult subjects and 22 patients with DAI who were classified according to Adams' classification(DAI I; 7, DAI II; 9 and DAI III; 6). The latencies and amplitudes of R1 and R2 in patients with DAI were compared with those of healthy subjects. The results were as follows; 1) In 20 subjects of patient group, the latencies of R1 were all within a normal range. In 2 subjects, the difference in latencies between the two sides was above 1.4 msec. 2) In 15 subjects, R2 was absent or delayed, and reduced in the size of amplitude in all. Nine were affected bilaterally, and 4 were unilaterally. 3) Seventy one percent of patients in each stage represented abnormal findings. 4) There were no correlations between the DAI stage and the blink reflex. This study demonstrated that the polysynaptic R2 was more profoundly suppressed than the oligosynaptic R1 in a diffuse axonal injury because of a loss or decrease of suprapontine facillitation, which influenced the trigeminal spinal complex and the interneuron of lateral reticular formation.
Adult ; Axons ; Blinking* ; Diffuse Axonal Injury* ; Humans ; Interneurons ; Reference Values ; Reticular Formation

The location of pelvic portion of the femoral nerve between the iliacus and psoas muscles makes the nerve particularly vulnerable in hemorrhage within iliacus. We report a uncommon case of bilateral femoral neuropathy resulting from unilateral retroperitoneal hematoma. A 28-year-old man developed zero-trace grade of muscular weakness on both knee extensor muscles, numbness over bilateral anteromedial thighs and medial lower legs, tenderness of both hip adductor muscles after stab wound at left abdominal region. Abdominal computerized tomographic finding showed hematoma of left psoas muscles. Electromyographic examination revealed no motor unit action potentials in both iliopsoas, vastus medialis and adductor longus muscles. Nerve conduction study noted no compound motor action potentials of both femoral nerves. The fascial walls and laminae of the pouches in the lower abdominal wall tend to reinforce the rigidity of the fibrous arch over the femoral nerve in the intermuscular groove. This neuropathy is suggested, when the pouches are filled with blood, would further increase pressure on the subjacent nerves, especially bilateral femoral nerves.
Abdominal Wall ; Action Potentials ; Adult ; Femoral Nerve ; Femoral Neuropathy* ; Hematoma* ; Hemorrhage ; Hip ; Humans ; Hypesthesia ; Knee ; Leg ; Muscle Weakness ; Muscles ; Neural Conduction ; Psoas Muscles ; Quadriceps Muscle ; Thigh ; Wounds, Stab

OBJECTIVE: The previously established method of carpal tunnel syndrome (CTS) diagnosis is relatively troublesome and risk of misleading due to uncertainty of exact distance measurement for stimulation. If we use the wrist crease, an anatomical landmark, there might not be error in length measurement for stimulation at any wrist position. This study was performed to evaluate the wrist stimulation method in the diagnosis of CTS for it's convenience and reducing the errors. METHOD: Seventy healthy adults and sixty-five patients with clinical and electrophysiologic evidence of CTS were studied. Sensory nerve action potentials (SNAPs) in second and fifth digit were recorded antidromically with stimulation at a distance of 14 cm from recording electrode and stimulation at wrist crease. The ratio and difference of distal latency and ratio of amplitude between median and ulnar SNAPs were assessed. RESULTS: The ratio and difference of distal latency and ratio of amplitude in the 14 cm stimulation method were 1.52+/-0.28, 1.59+/-0.91 msec, 1.26+/-0.27 in the right, 1.43+/-0.14, 1.29+/-0.42 msec, 1.18+/-0.20 in the left, respectively in the men patients, and those of women patients were 1.48+/-0.35, 1.43+/-1.04 msec, 1.18+/-0.30 in the right, 1.53+/-0.30, 1.46 0.80 msec, 0.75+/-0.36 in the left. In wrist crease stimulation, those of men patients were 1.72+/-0.39, 1.74+/-0.98 msec, 1.22+/-0.24 in the right, 1.53+/-0.21, 1.31+/-0.46 msec, 1.25+/-0.29 in the left, and those of women patients were 1.67+/-0.46, 1.56+/-1.01 msec, 0.63+/-0.32 in the right, 1.68+/-0.37, 1.56+/-0.82 msec, 0.68+/-0.30 in the left. These results showed a significant positive correlation between the patients group and the control group in two stimulation methods (p<0.001). CONCLUSION: Based on the result of this study, wrist crease stimulation method is a quick and easy procedure, which would be recommended in the early diagnosis of CTS.
Action Potentials ; Adult ; Carpal Tunnel Syndrome* ; Diagnosis* ; Early Diagnosis ; Electrodes ; Female ; Humans ; Male ; Uncertainty ; Wrist*

Skeletal muscles are known to have tolerance to ischemia, but a prolonged ischemia can cause damage to muscular tissues. The ischemia-reperfusion injury results from the oxygen free radicals released by leucocytes and formed by the reaction of hypoxanthine and xanthine oxidase. Superoxide dismutase (SOD), one of major antioxidant enzymes ocurring in the various tissues of the body metabolizes or scarvanges the oxygen free radicals. Although many studies reported difference in tolerance to ischemia and reperfusion between white and red muscles, some other investigators failed in finding such difference. The present study was performed to examine effects of graded periods of ischemia and reperfusion on the cellular ultrastructure and activity of SOD in white and red muscles. The Sprague-Dawley rats (200~250 g) were used as experimental animals. Under pentobarbital (50 mg/kg IP) anesthesia, incision was made on lower abdomen and left common iliac artery was occluded by means of a vascular clamp for 2, 4 and 6 hour (hrs). Thereafter, the superficial portion of mid-belly of anterior tibial muscle and soleus muscles were excised at 0, 24 and 72 hrs after onset of reperfusion. The specimens were sectioned into slices, 2 mm in length, 1 mm in width and thickness. Some specimens were prepared for electron microscopic observation and others for determination of SOD activity by using antihuman Cu, Zn- and Mn-SOD antibodies. The results obtained were as follows. 1. In anterior tibial muscle, areas with loose electron-density and dilated cristae were observed in the mitochondria immediately after 2 hrs of ischemia, while widened intermyofibrillar spaces and dilated cisternae of sarcoplasmic reticulum were seen after 2 hrs and 24 hrs reperfusion. When subjected to 2 hrs ischemia and 72 hrs reperfusion, no significant change was found in the cellular ultrastructure. 2. In soleus muscle, electron density was loose in the matrix of mitochondria immediately after 2 hrs of ischemia, while cisternae of sarcoplasmic reticulum were dilalated after 2 hrs of ischemia and 24 hrs reperfusion. Following 2 hrs of ischemia and 72 hrs reperfusion, the electron microscopic findings were similar to those of normal rats. 3. The changes in cellular ultrastructure were more prominent in both the 4 hrs and 6 hrs ischemia groups, in which degree of ultrastructural changes were proportional to duration of reperfusion. 4. In anterior tibial muscle, trace or weak immunoreactivities of Cu, Zn- and Mn-SOD were seen, whereas trace immunoreactivity of Cu, Zn-SOD and trace or weak immunoreactivity of Mn-SOD were observed in soleus muscle. 5. The immunoreactivities of Cu, Zn- and Mn-SOD were not altered in 2 hrs ischemic and 72 hrs reperfused group, while they were increased slightly in 2 hrs ischemic and 24 hrs reperfused group. 6. In both muscles, the activity of SOD increased following 4 hrs or 6 hrs ischemia and 24 hrs or 72 hrs reperfusion. The changes in immunoreactivity of Mn-SOD were not different between two muscles, whereas immunoreactivity of Cu, Zn-SOD were higher in anterior tibial muscle. Consequently, it is suggested that significant ischemia reperfusion injuries are produced after 4~6 hrs ishemia followed by 24 hrs or 72 hrs reperfusion, that anterior tibial muscle is more susceptible to ischemic reperfusion injury and that the ischemic-reperfusion injury is closely related with activity of SOD.
Abdomen ; Anesthesia ; Animals ; Antibodies ; Free Radicals ; Humans ; Hypoxanthine ; Iliac Artery ; Ischemia* ; Mitochondria ; Muscle, Skeletal ; Muscles* ; Oxygen ; Pentobarbital ; Rats* ; Rats, Sprague-Dawley ; Reperfusion Injury ; Reperfusion* ; Research Personnel ; Sarcoplasmic Reticulum ; Superoxide Dismutase ; Xanthine Oxidase

Palatal myoclonus (palatal tremor) was reported to be presented with a sole symptom of objective pulsating tinnitus and could be controlled by botulinum toxin injection alone. However, there were 3 cases reported in Korea of palatal myoclonus tinnitus controlled with botulinum toxin injection through the dual administration route of the mouth and nasal cavity. We present an 11-year-old boy of essential palatal myoclonus tinnitus, which was controlled by intraoral botulinum toxin injection to the tensor veli palatini muscle alone. Intraoral injection of botulinum toxin to the anatomical location of tensor veli palatini muscle with the guidance of electromyography was effective and safe for the child of objective tinnitus caused by palatal myoclonus.
Botulinum Toxins ; Child ; Electromyography ; Humans ; Korea ; Mouth ; Muscles ; Myoclonus ; Nasal Cavity ; Tinnitus

We present a 50-year-old woman who sustained spastic left hemiplegia secondary to the right thalamic hemorrhage 6 years ago. She complained of persistent severe left calf pain after serial casting for the treatment of shortened plantar flexors of the left ankle. Two months later, magnetic resonance T1-weighted images showed diffuse high signal intensity involving the whole muscle bulk of the soleus and normal signal intensity of thin atrophied gastrocnemius. Needle electromyography of the soleus revealed myopathic patterns. Histologic findings of the soleus showed necrotic muscle fibers with phagocytosis, endomyseal collagen and fat deposition. We concluded that prolonged passive stretch of spastic plantar flexors of the ankle under serial casting induced soleus myopathy with segmental myonecrosis, and which developed left calf pain. Selective induction of soleus myopathy could be explained by the higher stretch tension produced by ankle dorsiflexion in the soleus compared to the gastrocnemius because of different proximal ends.
Ankle ; Collagen ; Electromyography ; Female ; Hemiplegia ; Hemorrhage ; Humans ; Middle Aged ; Muscle Spasticity ; Muscular Diseases* ; Needles ; Phagocytosis ; Stroke*

Our objective is to evaluate the applicability of segmental phase angle (PhA) via bioelectrical impedance analysis (BIA) for post-stroke complex regional pain syndrome (CRPS). Due to its noninvasiveness and convenience, various studies have used BIA in clinical conditions. We measured segmental PhA in 4 patients at the time of CRPS diagnosis and repeated 4 weeks after 2 weeks of steroid pulse therapy. In 3 cases, the affected-to-unaffected ratio of the upper limb PhA decreased at the time of diagnosis. In 2 cases with improvement of more than 5 points in the CRPS severity score (CSS), increased ratios were observed. In other 2 cases with improvement of less than 4 points in the CSS, no remarkable changes in the ratios were found. We suggest that the segmental PhA can be helpful in assessment of post-stroke CRPS and its recovery.