Is superselective embolization of the brain AVMs, the possibilities of adjacent normal brain tissue damage necessitates preembolic evaluation. The authors performed the Sodium Amytal test on 15 patients with brain AVMs. In the AVM patients with negative Amytal test(30 cases), all patients showed normal pattern on EEG and neurologic examinations after embolization Among the five patients with positive Amytal test, three cases showed neurologic deficit and the others two didn't. In eleven patients. Repeated embolization without the Amytal test were done. Among them, 5 cases showed neurlogic deficit and the others were quite normal. In conclusion, the Amytal test is a useful method of evaluation of the risk to damage normal brain tissue which are supplied by superselected feeding vessels. Combining the EEG with this test is a sensitive and objective method in evaluating patients following the Amytal test. And it is essential to performed the Amytal test for repeat embolization procedures.
Amobarbital* ; Arteriovenous Malformations* ; Brain* ; Electroencephalography ; Humans ; Methods ; Neurologic Examination ; Neurologic Manifestations

neurologic examination of intracranial problems. Incidental abnormalities in the sinonasal area without clinical symptoms have been reported in about 38% of patients.SUBJECTS AND METHOD: The aim of this study was to evaluate the clinical characteristics of sinonasal surgical patients transferred from neurologists. Two hundred two patients were enrolled and divided into two groups. Group I patients had been directly transferred from the Neurology Department within 1 month after neurologic evaluation. Group II patients directly visited the Rhinology Department without a neurologic evaluation within the prior year. Both groups had received sinonasal endoscopic surgery or septal surgery. Clinical characteristics, pathologic findings, and surgical results were compared between groups.RESULTS: Headache and dizziness were common symptoms in group I. Group II patients displayed more severe sinus involvement with nasal symptoms. Fungal ball was the main pathologic finding in group I. Nasal polyps were common in group II. Most patients had improved symptoms after sinonasal surgery.CONCLUSION: Patients transferred from the Neurology Department had different clinicopathologic characteristics than patients without neurologic problems who had first been evaluated at the Rhinology Department.]]>
Dizziness ; Headache ; Humans ; Magnetic Resonance Imaging ; Methods ; Nasal Polyps ; Neurologic Examination ; Neurology

This paper introduces the latest developments of the monitoring techniques for electroencephalogram (EEG) bispectral index (BIS), pulse indicator continuous cadiac output (PiCCO), entropy index (ENTROPY), internal organs blood stream perfusion (TONO), neuromuscular transmission (NMT) and spirometry, and their clinical applications.
Electroencephalography ; methods ; Entropy ; Heart Function Tests ; methods ; Humans ; Monitoring, Physiologic ; methods ; Neurologic Examination ; methods ; Respiratory Function Tests ; methods ; Signal Processing, Computer-Assisted

OBJECTIVETo evaluate the consistency between the clinical diagnostic criteria and the ascertained diagnostic criteria for diabetic peripheral neuropathy (DPN) in the Preventive and Treatment Guidelines of Diabetes in China (2013) and explore an economic, convenient, and accurate approach to DPN diagnosis.

METHODSThe patients with type 2 diabetes admitted in our department from April to June, 2014 were examined for nerve conduction velocity, 10 g nylon silk, vibration threshold value, sense of temperature and pain, and ankle reflex. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value were calculated to assess the diagnostic power of the two diagnostic criteria.

RESULTSOf the 151 patients enrolled, 106 (70.2%) had a diagnosis of DPN consistent with the ascertained diagnostic criteria, as compared to 86 (56.95%) who were diagnosed according to the clinical diagnostic criteria; the latter patients accounted for 81.13% of former cases. The sensitivity, specificity, positive predictive value, negative predictive value, Youden index, and Kappa value of the clinical diagnostic criteria were 80.19%, 97.78%, 98.84%, 67.69%, 77.97%, and 0.69, respectively, which were highly consistent with those of the ascertained diagnostic criteria; the sensitivity to compression showed a poor consistency between the two diagnostic criteria. In the 5 screening tests, the combined test of temperature sensation, vibration perception, and ankle reflex showed the highest AUC value among their different combinations.

CONCLUSIONThe clinical diagnostic criteria for DPN show good consistency with the ascertained diagnostic criteria, and for patients with clinical symptoms or with only one positive sign, combination of the two diagnostic criteria can achieve the maximum diagnostic power.

China ; Diabetes Mellitus, Type 2 ; Diabetic Neuropathies ; diagnosis ; Humans ; Neurologic Examination ; methods ; Predictive Value of Tests ; Sensitivity and Specificity

OBJECTIVETo assess the predictive value of Neuropad test on occurrence of diabetic foot ulceration (DFU) among type 2 diabetic patients.

METHODSWe divided 725 cases of type 2 diabetic patients into the high-risk and the non-high-risk groups of DFU based on the results of vibration perception thresholds(VPT) examination, which was widely used as a criteria for predicting DFU. Receiver operating characteristic (ROC) analysis was used to compare the effectiveness of Neuropad with 10 g Semmes-Weinstein monofilament (10 g SWMF) testing in predicting the risk of DFU.

RESULTSAmong 725 patients of type 2 diabetes, 6.1% were at a high risk of DFU. Compared to non-high-risk group, patients in high-risk group had older age, longer diabetes duration, higher values of complete colour change time (CCC time) of Neuropad and higher abnormal rate of 10 g SWMF (P<0.01). CCC time of Neuropad was shown to be better in predicting the risk of DFU than 10 g SWMF, and the area under the ROC curve was about 0.8, and the best cut-off value was 22.25 min.

CONCLUSIONNeuropad is an effective means for predicting of the risk of DFU, and can be used to prevent diabetic foot ulceration.

Adult ; Aged ; Diabetic Foot ; diagnosis ; Female ; Humans ; Male ; Middle Aged ; Neurologic Examination ; methods ; Predictive Value of Tests ; Risk Assessment

OBJECTIVE: To evaluate the application value of Toronto clinical scoring system (TCSS) and its grading of neuropathy for diabetic peripheral neuropathy (DPN), and to explore the relationship between TCSS grading of neuropathy and the grading of diabetic nephropathy and diabetic retinopathy. METHODS: A total of 209 patients of Type 2 diabtes (T2DM) underwent TCSS. Taking electrophysiological examination as a gold standard for diagnosing DPN, We compared the results of TCSS score > or = 6 with electrophysiological examination, and tried to select the optimal cut-off points of TCSS. RESULTS: The corresponding accuracy, sensitivity, and specificity of TCSS score > or = 6 were 76.6%, 77.2%, and 75.6%, respectively.The Youden index and Kappa were 0.53 and 0.52, which implied TCSS score > or = 6 had a moderate consistency with electrophysiological examination. There was a linear positive correlation between TCSS grading of neuropathy and the grading of diabetic nephropathy and diabetic retinopathy (P<0.05). The optimal cut-off point was 5 or 6 among these patients. CONCLUSION TCSS is reliable in diagnosing DPN and its grading of neuropathy has clinical value.
Adult ; Aged ; Diabetes Mellitus, Type 2 ; complications ; Diabetic Neuropathies ; diagnosis ; physiopathology ; Electrophysiology ; Female ; Humans ; Male ; Middle Aged ; Neurologic Examination ; methods

Asphyxia Neonatorum ; complications ; Humans ; Hypothermia, Induced ; methods ; trends ; Hypoxia-Ischemia, Brain ; diagnosis ; therapy ; Infant, Newborn ; Neurologic Examination

The present study was done to validate the two-site Semmes-Weinstein (SW) monofilament test in identifying patients at risk of lower-extremity complications in clinical setting. The SW monofilament test and nerve conduction study were conducted on type 2 diabetic patients (n=37) at Pusan National University Hospital in Korea. As the duration of diabetes mellitus was longer, neuropathy identified by nerve conduction study and complications of diabetes were more severe (p<0.01). The number of sites unable to perceive SW monofilament (p<0.001) was larger in patients with lower-extremity neuropathy symptoms than those without symptoms. Sensitivity and specificity at two sites (the third and fifth metatarsal head sites) were 93% and 100%, respectively. In conclusion, the two-site SW monofilament test was a sensitive, specific, simple, and inexpensive screening tool for identifying diabetic peripheral neuropathy in clinical setting.
Aged ; Comparative Study ; Diabetes Mellitus, Type II/complications* ; Diabetic Neuropathies/diagnosis* ; Female ; Human ; Male ; Middle Aged ; Neural Conduction ; Neurologic Examination/instrumentation* ; Neurologic Examination/methods ; Pressure ; Sensation Disorders/diagnosis* ; Sensation Disorders/etiology ; Sensitivity and Specificity ; Touch

BACKGROUND AND PURPOSE: The objective of this study was to find a sensitive method for the early detection of diabetic polyneuropathy (DPN) and determine the relationship between the functions of somatic and autonomic small nerve fibers in DPN. METHODS: Patients with type 2 diabetes mellitus and DPN based on clinical symptoms, signs, intraepidermal nerve fiber density (IENFD), and findings in the quantitative sudomotor axon reflex test (QSART) were enrolled retrospectively. Neurological examinations and nerve conduction studies were performed on all patients. Heart-rate variability during deep breathing (DB ratio) and the Valsalva maneuver (Valsalva ratio) were used to quantify the cardiovagal function. Patients were divided into two groups: 1) normal nerve conduction, defined as small-fiber neuropathy (SFN) and 2) abnormal nerve conduction, defined as mixed-fiber neuropathy. RESULTS: In total, 82 patients were enrolled (age: 60.7±10.7 years, mean±SD). A decreased IENFD was the most frequent abnormality across all of the patients, followed by abnormalities of the QSART and cardiovagal function. A decreased IENFD was more sensitive than the QSART, DB ratio, and Valsalva ratio for detecting diabetic SFN. The DB ratio was significantly correlated with the duration of diabetes mellitus and clinical symptoms and signs. There was no correlation between the IENFD and the findings of the QSART for the distal leg. CONCLUSIONS: Measuring the IENFD was a more sensitive method than the QSART for the early detection of DPN. The degree of involvement of the somatic small nerve fibers and sudomotor nerve fibers was independent in DPN.
Axons ; Diabetes Mellitus ; Diabetes Mellitus, Type 2* ; Diabetic Neuropathies ; Humans ; Leg ; Methods ; Nerve Fibers* ; Neural Conduction ; Neurologic Examination ; Reflex ; Respiration ; Retrospective Studies ; Valsalva Maneuver

OBJECTIVE: To explore the application of quantitative temperature testing (QTT) in forensic identification and clinical diagnosis of neurogenic erectile dysfunction (NED). METHODS: TSA-II-NeuroSensory Analyzer was used to measure the thresholds of four kinds of sensory, including cold, cold pain, heat, heat pain, in 22 normal and 35 NED patients at dorsal glans (DG), left thigh interior (LTI) and left thenar (LT). To calculate the relative thresholds of the sensory mentioned above between DG and LTI (DG/LTI), and between DG and LT (DG/LT). Then to analyze those thresholds and the relative thresholds. RESULTS: NED group showed significant higher threshold than the normal group in DG-heat, DG-heat pain, LTI-heat, LTI-heat pain, DG/LTI-heat, DG/LT-heat, DG/LT-heat pain (P < 0.05). CONCLUSION The threshold of QTT at dorsal glans could be used as an accessory indicator in forensic medicine and clinical diagnosis of NED.
Adult ; Case-Control Studies ; Erectile Dysfunction/physiopathology* ; Hand/physiology* ; Humans ; Male ; Nervous System Diseases/physiopathology* ; Neurologic Examination/methods* ; Pain Threshold ; Penis/physiopathology* ; Sensory Thresholds ; Temperature ; Thermosensing