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Objective: To assess magnetic resonance imaging (MRI) findings in carpal tunnel syndrome (CTS) and to compare them with electrophysiological findings., Methods: Routine motor and sensory nerve conduction examinations and needle EMG were performed in 42 hands of 22 patients, who were clinically diagnosed as having CTS in at least one wrist., Results: Of 29 wrists with clinically and electrophysiologically confirmed CTS, MRI could detect abnormality in 18 wrists (62%). Median nerve was found to be abnormal in MRI in 1 of 2 wrists with suspected clinical symptoms and proven CTS by electrophysiological examination. MRI was abnormal in 1 of 4 wrists with normal clinical and electrophysiological examination. MRI was abnormal in 46, 7% of wrists with mild CTS, in 61.6% of moderate CTS and in 100% of severe CTS. Volar bulging of the flexor retinaculum was detected in a single wrist with severe CTS. Enlargement of median nerve was observed in 3 of 5 severe CTS., Conclusion: MRI could be useful in the diagnosis of unproven cases in CTS. It also provides anatomical information that correlate well with electrophysiological findings in regard of the severity of median nerve compression.

Objectives: The aim of this study was to investigate the changes in cortical excitability in patients with hemifacial spasm (HFS) in order to examine the physiological state of facial nerve nucleus., Methods: Nineteen patients with HFS and 13 control subjects were examined at rest. The procedure was repeated during voluntary contraction in 6 of control subjects. By paired transcranial magnetic stimulation, conditioning and test motor evoked potentials (MEP) were recorded from bilateral orbicularis oris muscles at interstimulus intervals (ISI) of 20, 25, 30, 50, 75 and 100 ms., Results: In control subjects at rest, ISI's of 20, 25, 30 ms evealed facilitation of the test MEP and inhibition developed at ISI's of 75 and 100 ms. Test MEP facilitation in the contracting controls and on the symptomatic sides of HFS patients was significantly less than the resting controls. Asymptomatic sides of HFS patients behaved similar to the corresponding symptomatic sides and to the contracting controls, although the values were not statistically significant when compared to the resting controls., Conclusion: The lessening of facilitation found in this study can be interpreted as an abnormal finding that reflects the changes in the excitability of facial motoneuronal system in patients with HFS. However it is difficult to exclude the possibility that this finding can occur due to the normal behavior of cortex during voluntary or involuntary contraction.

In 35 patients with idiopathic facial palsy (FP) clinical and electrophysiological examinations were performed during the first month. The patients were followed up until the 4th month to establish the prognostic value of different electrophysiological tests. Electrophysiological investigations consisted of the recording of blink reflex (BR) and the recording of the direct response (DR) elicited by the stimulation of the facial nerve. FP recovered satisfactorily in 80% of the patients. In patients in whom marked paresis remained, DR amplitude ratio of the affected side to the healthy side (DRr) was less than 25%. BR indicated a poor outcome, if it was still absent at the first month. In general, BR and DR measurements gave similar information about prognosis. Rare exceptions could be explained by the representation of different mechanisms by these two methods, demyelination and axonal degeneration.