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Spinocerebellar ataxia (SCA) is an autosomal dominant hereditary disease with a low prevalence, for which more than 50 types have been described. This group of neurodegenerative diseases can present as different phenotypes with varying progression rates and clinical manifestations of different severities. Herein, we systematically reviewed existing medical literature to describe the main characteristics of polyneuropathy in patients with SCA types 2, 3, and 10. Using relevant keywords, 16,972 articles were identified from the databases. Of these, 5,329 duplicate studies were excluded before screening. Subsequently, 11,643 studies underwent title and abstract review, of which only 49 were selected for full-text review. Among these, 24 studies were included. The medical literature suggests peripheral neuropathy - probably in a polyneuropathy phenotype - in SCA types 2 and 3. It is not possible to determine whether there is peripheral neuropathy in patients with SCA type 10, as there is only one case series in Mexico that described peripheral neuropathy in this group. Further studies are required to investigate peripheral neuropathy in patients with SCA types 2, 3, and 10. The study and description of a possible statistical association between CAG repeats and SARA scale scores with the presence of peripheral neuropathy are important points requiring assessment in future research. [ABSTRACT FROM AUTHOR]

Aim: Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy resulting from compression of the median nerve at the wrist level. Increased intercarpal canal pressure plays an important role in the etiology of CTS. Although most cases are idiopathic, there may also be some systemic or local causes. The aim of this study was to evaluate the demographic and etiological characteristics of patients with CTS who applied to our electroneuromyography (ENMG) laboratory within 3 months. Material and Methods: One hundred forty-nine patients (=298 hands) who were sent to our ENMG laboratory for ENMG evaluation and diagnosed with CTS were included in our study. Cases with cervical vertebral root lesions, thoracic outlet syndrome, polyneuropathy, trauma such as nerve injury, and cases with tumors and secondary CTS to pregnancy were excluded from the study. Results: One hundred six (71.1%) of the cases in our study were women and 43 (28.9%) were men. The average age of the patients was 54.27±13.10, and the body mass index (BMI) was 27.92±3.98. BMI ≥30 was found in 47 (31.5%) of the patients. In our study, we found that housewives were the occupational group with the highest risk in terms of CTS (n=94, 63.1%). In this study, we found bilateral hand involvement in 93 (62.4%) patients. The most common condition was idiopathic CTS (n=81, 54.6%). Conclusion: CTS is more common in postmenopausal women who work as housewives and is usually seen in the dominant hand. It was concluded that this study would be useful for the diagnosis of CTS. [ABSTRACT FROM AUTHOR]

At 4 months of age, a male dog was presented with a complaint of a stiff gait following a startle response. Neurological examination revealed no deficits, but clinical myotonia was easily induced upon requesting the patient to jump. Additionally, myotonia of the upper lip muscles was observed upon manipulation. Hereditary myotonia was suspected, and electromyography confirmed the presence of myotonic potentials. Genetic testing of the myotonic patient identified a complex of mutations, including c.[1636_1639 delins AACGGG] and c.[1644 A>T], both located in exon 15 of the CLCN1 gene leading to the formation of a premature stop codon. Genetic investigations of the mother and four littermates revealed that, except for one littermate who was wild type, all others carried a copy of the mutated gene. To the best of the authors' knowledge, these mutations have not been previously reported. [ABSTRACT FROM AUTHOR]

Ulnar neuropathy at the elbow (UNE) is the second most common entrapment neuropathy and presents with symptoms such as pain, paresthesia, and weakness in the elbow. Provocative tests and electrophysiological examinations are helpful in the diagnosis of UNE. Low-level laser therapy is one of the conservative treatments of UNE however, limited results were reported on the effectiveness of low-level laser therapy (LLLT) in the treatment of UNE. In our study, we aimed to the efficacy of LLLT in reducing symptoms and providing clinical and electrophysiological improvement in patients with UNE. This study with a randomized-sham controlled, and double-blind design included 68 patients aged 18–60 years who were diagnosed with UNE. LLLT was applied to the first group, and sham laser was applied to the second group. The VAS pain, paresthesia, and weakness scores, grip strength, and provocative test positivity were evaluated in clinical examination. The QuickDASH questionnaire was administered to assess functional status. Electrophysiologically, motor distal latency (MDL) differences, sensory distal latency (SDL), motor and sensory nerve conduction velocity (NCV) were examined. Evaluations were performed before treatment and on the 15th day and at the third month after treatment. The LLLT group showed improvement in symptoms, clinical findings, motor NCV, and MDL at both post-treatment evaluations and sensory NCV on the post-treatment 15th day (p < 0.05). The comparison of post-treatment changes between the two groups revealed that the LLLT group had greater improvement in VAS day and night pain scores at both post-treatment evaluation times, QuickDASH scores at the third month, and sensory NCV on the 15th day (p < 0.05) compared to the SL group. There were no significant differences between the groups in terms of the post-treatment changes in VAS weakness scores, grip strength and electrophysiological findings (p > 0.05). It was observed that splinting alone was effective in UNE, but the addition of LLLT, one of the conservative treatment methods, enhanced treatment outcomes. [ABSTRACT FROM AUTHOR]

The main objective of the research consists in providing evidence that a long-term rehabilitation protocol is favorable for the patient. In adult brachial plexus (BP) palsies, after several surgical attempts, the lack of results in the upper limb's functionality leads to less compliance to rehabilitation therapy. The upper limb's functionality of 22 patients with posttraumatic operated chronic BP paresis (either on the right or left, regardless the dominant limb) was assessed retrospectively. The patients were evaluated regarding MRC scaling, dynamometric tests and electroneuromyographic examination. All patients have gone through at least one rehabilitation interval (10 days) after an initial evaluation, and were evaluated again, by same methods, at a second session, at least 6 months later, but no more than one year. Mild and inconstant improvements were obtained in a total of 9 patients, especially in better dynamometric results and improved amplitudes of motor and sensory action potentials. The electrodiagnosis correlates with dynamometric parameters (muscle strength) and slight amelioration of the motor deficit. Given the small sample size as a limitation, as well as no standardized therapeutic protocol, it should be noted that the 9 patients were the only ones who either attended more than one interval or did more procedures as frequency in time (more often meaning 3 times weekly for 6 months, in 6 patients). Although the most frequent procedures were neuromuscular electrical stimulation (NMES) and proprioceptive neuromuscular facilitation (PNF), the results suggest that regardless of the techniques, the more active patients had better results. Proving the need for long-term rehabilitation, even contrary to the less visible results, can be the trigger point for future research and therapy strategies, as the results suggest central mechanisms involved, adding the cortical ongoing plasticity into the equation. [ABSTRACT FROM AUTHOR]

The dynamics of nephropathy development in rats with type 2 diabetes mellitus, caused by a high-fat diet and the streptozotocin administration (25 mg/kg), and metabolic syndrome, caused by addition of 20% fructose solution to the diet, was evaluated during the experiment. Models with moderate severity of metabolic changes without significant changes in body weight were obtained after 24 weeks. To study neuropathy severity, the method of electroneuromyography was used; the velocities of motor and sensory excitation propagation along the caudal nerve fibers were measured. In modeled diabetes mellitus against the background of hyperglycemia, a marked decrease in motor and sensory propagation rates was observed, and an increase in the response durations was noted from week 12 to week 24, indicating pronounced neuropathy. In the fructose model, the motor response duration increased from week 12, which possibly indicates the development of peripheral neuropathy. [ABSTRACT FROM AUTHOR]

At 4 months of age, a male dog was presented with a complaint of a stiff gait following a startle response. Neurological examination revealed no deficits, but clinical myotonia was easily induced upon requesting the patient to jump. Additionally, myotonia of the upper lip muscles was observed upon manipulation. Hereditary myotonia was suspected, and electromyography confirmed the presence of myotonic potentials. Genetic testing of the myotonic patient identified a complex of mutations, including c.[1636_1639 delins AACGGG] and c.[1644 A>T], both located in exon 15 of the CLCN1 gene leading to the formation of a premature stop codon. Genetic investigations of the mother and four littermates revealed that, except for one littermate who was wild type, all others carried a copy of the mutated gene. To the best of the authors' knowledge, these mutations have not been previously reported.

Background and aim: Carpal tunnel syndrome (CTS) is a compressive neuropathy caused by compression of the median nerve in the carpal tunnel. It is the most common entrapment neuropathy. According to different studies, the prevalence of CTS among adults (15–65 years old) in Western Europe ranged from 0.29% to 43%. CTS affects middle-aged active workers and is associated with high healthcare costs and a hefty economic burden. It is thus essential to diagnose CTS early and refer the patient to further investigation and treatment. In this study, we aimed to evaluate the accuracy of the clinical CTS diagnosis before the nerve conduction studies were performed on the referred patients.Methods: The concordance of clinical diagnoses was assessed by comparing referral diagnoses with diagnoses confirmed by electroneuromyography. All the patients referred for electroneuromyography to Mykolas Marcinkevičius Hospital between August 2023 and February 2024 were included in this research. The age, sex, referral and final diagnoses of the enrolled patients were taken from their outpatient charts. The obtained data were summarized and processed with Microsoft Office Excel 365, and the data analysis was performed with IBM SPSS Statistics.Results: The most common reasons that patients were referred to perform NCS were suspected carpal tunnel syndrome (30.7%), cubital tunnel syndrome (13.5%), other upper extremity mononeuropathies (16.2%), and polyneuropathies (15.5%). The most common diagnosis after consultation was carpal tunnel syndrome (42.6%), followed by pathologies of nerve roots or plexuses (14.5%). Out of 91 patients referred to electroneurography due to suspicion of CTS, 67 (73.6%) were confirmed cases, whereas, for 12 (13.2%) patients, no abnormalities were detected during NCS.Conclusion: Our analysis supports the theory that the electrodiagnostic examination is essential to specify and confirm the diagnosis of CTS, thus avoiding hyperdiagnosis and preventing patients from excessive surgical treatment.

Human adaptation to physical activity is manifested through mobilization of functional reserves. The purpose of this study was to provide a scientific and experimental substantiation of the adaptation of functional reserves of the motor system in athletes to specific sports activities from the standpoint of the physiological and biomechanical approach. Materials and methods. The study involved 704 elite athletes doing various sports. Reaction time was determined using the hardware and software package “Sports Psychophysiologist”. Stabilometric parameters were analysed using stabilometric platforms with the Smart BTS Motion System (BTS Bioengineering, Italy); the static analysis test protocol was applied. Electromyographic and biomechanical (kinematic and dynamic) movement control was performed using the Smart BTS Motion System as well. Functional reserves of the motor system were studied in line with the existing ideas about the components of the human body’s physiological reserves activated when doing sports. The following were evaluated: sensory systems (sensorimotor reactions, vestibular stability), movement control (stabilography, kinematics, dynamics), regulation of homeostasis, and implementation of activity (neuromuscular system). Results. We found that both single (in respect of urgent adaptation: an increase in voltage, optimization of kinematics and dynamics during a weightlifting snatch) and systematic (as regards long-term adaptation: improvement in reaction time and vestibular stability in athletes of various sports) training sessions involving maximum strength, power and speed contribute to the activation of the relevant sensory systems, central nervous system and muscular system, which form the basis of the motor system and increase its functionality as a whole.

The article is devoted to the issues of peripheral nervous system damage in new coronavirus infection. Among the nosologic forms of peripheral nervous system lesions in new coronavirus infection are mononeuropathies, polyneuropathies, multiple neuropathies, and noninflammatory polyneuropathies. In the largest retrospective study to date of cranial nerve pathology in COVID-19, dysfunction was observed in 38% of infected individuals. Facial nerve involvement was most common (30%). The article presents a clinical observation of facial nerve neuropathy after a new coronavirus infection with an assessment of the clinical picture, data of laboratory and instrumental investigations, therapy and long-term results. A possible causal relationship between COVID-19 and peripheral nervous system lesions is discussed.

Cubital tunnel syndrome is a symptomatic dysfunction of the ulnar nerve, resulting from compression of the nerve within the walls of the tunnel. This condition causes irreversible sensory disturbances, muscle weakness in the hand, trophic disorders, and the formation of secondary contractures. There is temporary loss of ability to work. Therefore, the issues of surgical interventions before the appearance of symptoms are important. The article presents an observation of a 35-year-old male with compression ischemic neuropathy of the ulnar nerve at the cubital tunnel level. Microsurgical decompression of the left ulnar nerve at the cubital tunnel level and neurotization of the motor portion led to a complete regression of pain, motor disorders, sensory disturbances and a significant improvement in functional condition. The issues of diagnosis, conservative and surgical treatment of cubital tunnel syndrome are discussed.

Carpal tunnel syndrome (CTS) is the most common cause of peripheral compressive neuropathy and consists of compression of the median nerve in the wrist. Although there are several etiologies, idiopathic is the most prevalent origin, and among the forms of treatment for CTS, conservative is the most indicated. However, despite the high prevalence in and impact of this syndrome on the healthcare system, there are still controversies regarding the best therapeutic approach for patients. Therefore, noting that some studies point to vitamin D deficiency as an independent risk factor, which increases the symptoms of the syndrome, this study evaluated the role of vitamin D supplementation and its influence on pain control, physical examination and response electroneuromyography to conservative treatment of carpal tunnel syndrome. For this, the sample consisted of 14 patients diagnosed with CTS and hypovitaminosis D, who were allocated into two groups. The control group received corticosteroid treatment, while the experimental group received corticosteroid treatment associated with vitamin D. Thus, from this study, it can be concluded that patients who received vitamin D, when compared to those who did not receive it, showed improvement in the degree of pain intensity, a reduction in symptom severity and an improvement in some electroneuromyographic parameters. [ABSTRACT FROM AUTHOR]

Neuropathy of the inferior alveolar nerve in recent years is one of the most common complications after dental interventions, accompanied by severe pain and sensitivity disorders. Clinically, iatrogenic neuropathy of the trigeminal nerve is represented, as a rule, by the presence of constant aching, burning or dull pain in the area of innervation of the affected nerve, against which neuralgic paroxysms occur with irradiation of pain, respectively, to the segmental areas of the face. The autonomic nervous system is often involved in the process. Unfortunately, at present there is no uniform treatment protocol for this pathology. As is known, botulinum toxin type A has a direct effect on pain afferents and an analgesic effect when administered locally into areas of sensitivity disorder. The aim of study to analyze the effectiveness of treatment methods for patients with iatrogenic neuropathy of the inferior alveolar nerve after surgical intervention using botulinum toxin type A. 70 patients took part in the study. For a comparative assessment of the effectiveness of treatment, they were divided into two groups: group 1 - patients who received conservative drug treatment; group 2 - conservative drug treatment in combination with botulinum therapy. Dynamic observation and evaluation of the effectiveness of treatment were carried out before the start of treatment, after 3 and 6 months. A comparative analysis of the effectiveness showed that the method of complex therapy using injections of botulinum toxin type A in group 2 demonstrated more pronounced positive dynamics than in patients of group 1. The results of our studies confirmed that botulinum therapy is a modern clinically proven method for relieving pain and sensory disorders in neuropathy. [ABSTRACT FROM AUTHOR]

Little attention has been paid abroad to the problem of the long-term course of multifocal motor neuropathy (MMN). In our country, catamnestic studies of MMN have not been conducted at all. However, the results of such an analysis are extremely important for understanding the course and prognosis of the disease.Objective: to analyse the clinical and neurophysiological data of patients with MMN with a disease duration of more than 5 years.Material and methods. The study included 28 patients with MMN: 9 women (32%) and 19 men (68%); the median age at admission was 50 [44; 56] years; the median disease duration was 10 [8; 13] years. Medical documentation, medical history, complaints, neurological examination results (scored on the MRC and INCAT scales) and results of electroneuromyography (ENMG) of the long nerves of the hands were analysed.Results. The median time between onset of the disease and diagnosis was 5.5 [2; 10] years. Paresis 0.05). An objective assessment of sensory disorders revealed no changes when testing tactile, pain and temperature sensitivity, while half of the cases (14/28; 50%) showed a disturbance of vibration sensitivity in the lower extremities. The ENMG examination was consistent with the electrophysiological criteria of the disease, one third of the patients showed significant secondary damage to the axons of the motor fibers of the hand nerves, and in half of the cases a slight impairment of the axons of the sensory fibers was registered.Conclusion. MMN is a curable disease. Unfortunately, our retrospective analysis showed that in the Russian Federation there are problems with its diagnosis and quality care of this category of patients. Late diagnosis, delayed start of treatment and non-compliance with the schedule of pathogenetic therapy lead to persistent disability of patients.

Introduction: It is aimed to investigate the relationship between the asymptomatic individiuals with elevated HbA1c and occurrence of polyneuropathy by way of comparison to normoglycemic condition. Methods: The study includes 30 female patients diagnosed with subclinical elevation of HbA1c and 30 normoglycemic healthy female patients who applied to our hospital polyclinics with symptoms other than neuropathy between January-March 2017. Nerve conduction examination is done in these patients, parameters of both groups are compared. Results: In regard to amplitude distribution; when compared to control group, tibial motor and ulnar sensory nerve amplitude is lower than the control group (p<0.05). In peroneal, median and ulnar motor nerves, distal latency values are extended compared to control group (p<0.05). Sural, median and ulnar sensory nerve latency is extended compared to control group. In terms of transmission rate distribution; in sural, median and ulnar sensory nerve, transmission speed is lower compared to the control group (p<0.05) Conclusions: In asymptomatic cases with subclinical elevation of HbA1c, peripheral nervous system involvement is monitored, and early glycemic control should be provided in order to prevent development of neuropathy in patients. [ABSTRACT FROM AUTHOR]

Background. Cerebral palsy is the most common cause of childhood disability among diseases of the nervous system, the prevalence of which averages 2.5 cases per 1,000 children.Aim. To identify relevant indicators in relation to the prediction of delayed rates of neuropsychic development in children and the formation of cerebral palsy in children 5–8 years old using mathematical modeling.Materials and methods. The study included 100 patients aged 5–8 years: 79 patients with neurological disorders and deviations in psycho-speech development, 21 patients – comparison group. The examination of children in both groups included: analysis of the child’s life history, analysis of psychomotor development in the first year of life, analysis of morbidity in the first year of life, assessment of psychomotor development at the time of the study, electroneuromyography using stimulation and superficial electroneuromyography, as well as ultrasound examination of the lower leg muscles with assessment of the functional state and muscle density using fibroscan.For statistical processing of the obtained data, descriptive statistics were performed. Determination of the statistical significance of indicators was carried out using the Kolmogorov–Smirnov test for continuously distributed values and Fisher’s exact test for discrete values. One-hot coding was used to represent categorical features. The analysis of the obtained data was carried out using a Python program using the pandas, numpy, scikit-learn, and boruta libraries.Results and conclusion. For children with deviations in neuropsychic development, significant early diagnostic markers are parameters of psychomotor development and neurological status (age when the child began to hold his head, decreased strength of the flexors of the foot and hip, level of walking) and instrumental examination (ultrasound of muscles thighs, electroneuromyography) – changes in the density and parameters of electrical excitability of muscles, which can serve as an early diagnostic sign of the development of motor dysfunction and an indicator for the formation of a trajectory of rehabilitation therapy.

Introduction. Despite the improving diagnostic criteria for the chronic inflammatory demyelinating polyradiculoneuropathy (CIDP), its verification is still an issue. Objective: to study the rate and the causes of CIDP misdiagnosis. Materials and methods. We prospectively and retrospectively analyzed the clinical and paraclinical data of 223 patients admitted to the Research Center of Neurology from 2018 to 2022 with a CIDP referral. Results. We revised the CIDP diagnosis in 150/223 patients (67%; median age 55.5 [43; 63] years; 75 males and 75 females; 3-year follow-up history [1.75; 5.25].) Once the definitive diagnosis was clarified, we divided the patients into the following groups: polyneuropathy of other etiology (n = 94; 63%), other neuromuscular disorders (n = 39; 27%), CNS disorders (n = 10; 7%), no structural NS disease (n = 7; 5%). Patients did not meet the 2021 EAN/PNS diagnostic criteria at the history-taking stage in 65% of cases, at the neurological examination stage in 39% of cases, and at the electroneuromyography stage in 92% of cases. Conclusions. The rate of CIDP misdiagnosis in Russia is 67%, and most often this refers to patients with polyneuropathy of other etiologies. The main cause for the CIDP misdiagnosis was inaccurate electroneuromyography. We should bear in mind that CIDP is a rare disorder with an extensive differential diagnosis, so it should be verified according to the current 2021 EAN/PNS diagnostic criteria.

ABSTRACT Neural leprosy, which is characterized by nerve involvement without visible skin lesions, presents a diagnostic challenge. This case report examined the significance of diverse diagnostic modalities in the identification of pure neural leprosy. A 28-year-old patient with symptoms of edema, pain, paresthesia, and diminished sensitivity in the lower limbs underwent various tests. A stilt skin smear yielded negative results on bacilloscopy, whereas a Fast ML Flow leprosy test and electroneuromyography supported the diagnosis. This discussion highlights the importance of accessible methods for early investigation. This study emphasizes the multidisciplinary approach and value of the Fast ML Flow leprosy test and electroneuromyography for diagnosing neural leprosy.

Background: The consequences of exposure to mercury and its compounds on the reproductive potential and health of offspring are a pressing problem for the global scientific community. The purpose of this study was to examine the effect of mercury chloride toxicity in the parent rats on the postnatal development, behavior, and neuromuscular conductivity of their adult offspring. Methods: The experiments were conducted in parental Wistar rats of both sexes, which were subcutaneously injected daily with mercury chloride solution (HgCl2) at a rate of 0.5 mg/kg before mating for 6 weeks. We assessed the postnatal mortality, body weight, surface righting reflex and motor activity of the newborn offspring. The examination of the adult offspring included open field, resident-intruder and rotarod tests, development of the food-procuring reflex, and electroneuromyography examinations. Results: The study results showed that exposure to HgCl2 in parental rats of both sexes before mating resulted in low motor activities and failure of impulse conduction in the neuromuscular apparatus of the hind limbs in the offspring. In addition, maternal exposure to HgCl2 before mating led to failure of the cognitive abilities in the adult offspring while the paternal exposure led to a decline in the offspring's aggressiveness. Conclusion: The study results supported the need for further investigation on the long-term effects of mercury toxicity on the rats' generations, and the mechanism of transmission of the "chemical load" from generation to generation. [ABSTRACT FROM AUTHOR]

Spinal muscular atrophy (SMA) is a neuromuscular disorder characterized by the degeneration of the anterior horn cells of the spinal cord. Nusinersen for the treatment of SMA has been covered by public healthcare in France since May 2017. Our aim was to investigate whether there is a correlation between clinical and compound motor action potential (CMAP) measurements in SMA patients treated with nusinersen after 3 years' follow-up. Motor skills were evaluated regularly between M0 and M36 using the Motor Function Measure (MFM) score. CMAP measurements were collected regularly between M0 and M22. Data for 10 patients with SMA type 2 were collected and divided into two age groups (< 5 years and > 5 years). Motor function improved, but not significantly, regarding distal motor skills (D3) in both groups, and in axial and proximal motor function (D2) in the younger group. CMAP measurements improved in all patients. CMAP increased significantly for the median nerve, and this improvement correlated significantly with global MFM and with axial and proximal tone (D2). Our study shows gain in distal motor function with nusinersen, especially in younger patients with SMA type 2. These results encourage the screening of SMA patients and treatment as early as possible. CMAP measurements of the median nerve show clear improvement in patients treated with nusinersen and could be performed as routine follow-up. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to assess the peripheral nerve injuries among survivors after the two consecutive Kahramanmaraş Earthquakes with magnitudes of 7.7 Mw and 7.6 Mw. Materials and Methods: In the study, the medical records and electroneuromyographic findings of 94 earthquake victims who referred to Ankara City Hospital and underwent electroneuromyography analysis were analyzed. Results: Peripheral nerve damage was most common in the lower extremities. The presence of crush syndrome was closely associated with peripheral nerve damage (p=0.049). Conclusion: Peripheral nerve injuries require special attention as they may cause serious disability. [ABSTRACT FROM AUTHOR]

Guillain–Barré syndrome (GBS) is an immune-mediated poly(radiculo)neuropathy with a variable clinical outcome. Identifying patients who are at risk of suffering from long-term disabilities is a great challenge. Biomarkers are useful to confirm diagnosis, monitor disease progression, and predict outcome. The authors provide an overview of the diagnostic and prognostic biomarkers for GBS, which are useful for establishing early treatment strategies and follow-up care plans. Detecting patients at risk of developing a severe outcome may improve management of disease progression and limit potential complications. Several clinical factors are associated with poor prognosis: higher age, presence of diarrhea within 4 weeks of symptom onset, rapid and severe weakness progression, dysautonomia, decreased vital capacity and facial, bulbar, and neck weakness. Biological, neurophysiological and imaging measures of unfavorable outcome include multiple anti-ganglioside antibodies elevation, increased serum and CSF neurofilaments light (NfL) and heavy chain, decreased NfL CSF/serum ratio, hypoalbuminemia, nerve conduction study with early signs of demyelination or axonal loss and enlargement of nerve cross-sectional area on ultrasound. Depicting prognostic biomarkers aims at predicting short-term mortality and need for cardio-pulmonary support, long-term patient functional outcome, guiding treatment decisions and monitoring therapeutic responses in future clinical trials. [ABSTRACT FROM AUTHOR]

Introduction. One of the additional instrumental methods for diagnosing pudendal neuropathy is needle electroneuromyography (ENMG) of the bulbocavernosus reflex (BCR). The accumulated data on ENMG BCR in patients with primary chronic pelvic pain syndrome (CPPS) are insufficient due to the specificity of the procedure and its performance only in expert centres that specialise in the treatment of pelvic pain. Therefore, a study to investigate the features of ENMG BCR in patients with CPPS is of increased interest.Objective. To assess the representativeness and informativeness of the ENMG BCR technique in patients with CPPS and to identify factors influencing changes in the main parameters of the BCR M-response such as latency, amplitude, and duration.Materials & methods. Retrospective cohort study, which included 75 data from patients with (CPPS) who underwent needle-guided ENMG recording of BCR. Subjective complaints of patients were recorded using validated questionnaires: visual analogue scale (VAS) and chronic prostatitis and male pelvic pain syndrome symptom scale index (NIH-CPSI). Basic ENMG parameters such as the amplitude, latency, and duration of the M-responses were recorded.Results. We found statistically significant correlations between the duration and height of the M response of the patients (r = 0.31, p = 0.03) and their body weight (r = 0.34, p = 0.02). Anthropometric data did not correlate with amplitude and latency. Significant excess latency above 45 ms was observed, confirming nerve tissue destruction, in 11 (55%) women and 24 (44%) men. Although there were no statistically significant differences in any of the M-response parameters between men and women, there was a tendency for an increase in response amplitude in men and an increase in BCR latency time in women.Conclusion. The results of our study show that the duration of the M-response of BCR can correlate positively with the anthropometric data of the patient. At the same time, the mean latency and amplitude of the response are independent of anthropometric data, and the difference between them may be more determined by sex differences.

IntroductionLeprosy is one of the most common infectious cause of peripheral neuropathy in the world and can lead to sequelae and physical disabilities. Electroneuromyography (ENMG) is the gold-standard test for evaluating neural impairment, detecting from subclinical abnormalities to advanced lesions. This study aims to describe the electroneuromyographic findings in patients with leprosy, according to their clinical forms.MethodsThe study is a retrospective observational analysis of the medical records of patients with leprosy, of a National Reference Center of Sanitary Dermatology and Leprosy in Brazil between 2014 and 2022. 513 patients underwent ENMG at leprosy diagnosis and also underwent a clinical, serological and molecular evaluation of the disease.ResultsThe electroneuromyographic findings showed 2,671 altered nerves, with an average of 6.9 (±5.1) altered nerves per patient. The most affected sensory nerves were the superficial peroneal (25.0%; 413/1649), sural (15.1%; 397/2627) and ulnar (13.8%; 363/2627), with average of 4.3 (±3.2) affected sensory nerves per patient. The most affected motor nerves were the ulnar (33.1%; 338/1022) and common peroneal (12.1%; 319/2627), with average of 2.6 (±2.5) motor nerves affected per patient. 126 patients presented normal ENMG and, among the 387 with abnormalities in the exam, 13.2% (51/387) had mononeuropathy and 86.8% (336/387) had multiple mononeuropathy. Axonal involvement was more frequent in primary neural leprosy, borderline-tuberculoid, borderline-lepromatous and lepromatous forms.DiscussionOur findings support that leprosy is a spectral disease, characterized by a balance between host immunity and bacillary load. Therefore, the impairment and electroneuromyographic characteristics are distinct and may vary according to the clinical form.

Background. Carpal tunnel syndrome is the most common and widespread peripheral neuropathy in the world. The diagnostic testing methods for the carpal tunnel syndrome are based on anamnesis data, objective and instrumental inspection. Electroneuromyography is the main instrumental test when carpal tunnel syndrome is suspected. An ultrasound imaging may also be performed. Objective. To determine the effectiveness, sensitivity and specificity of instrumental diagnostics methods used to diagnose the carpal tunnel syndrome, and to compare them. Methods. Diagnostic testing – ultrasound and electroneuromyography was applied to persons under study. The area of the median nerve (mm2) was assessed during the ultrasound examination. The results of the electroneuromyography study evaluated the response speed of the sensory impulse (ms), the speed of the motor impulse response (ms). Later, the tests, their sensitivity and specificity were evaluated and compared. Results. 30 patients participated in the study, of which 26 (86.7%) were women, 4 (13.3%) were men. Electroneuromyography was found to be both sensitive and specific for a measure of sensory propagation velocity, 76.2 and 75%, respectively (p = 0.042); of motor propagation speed – 100 and 75% (p = 0.040). Ultrasonography is sensitive (87.5%) but nonspecific (66.7%) (p = 0.008). The study showed that the ultrasound dimension strongly, directly and reliably correlates with the sensory impulse response rate (p

Background. Carpal tunnel syndrome is the most common and widespread peripheral neuropathy in the world. The diagnostic testing methods for the carpal tunnel syndrome are based on anamnesis data, objective and instrumental inspection. Electroneuromyography is the main instrumental test when carpal tunnel syndrome is suspected. An ultrasound imaging may also be performed. Objective. To determine the effectiveness, sensitivity and specificity of instrumental diagnostics methods used to diagnose the carpal tunnel syndrome, and to compare them. Methods. Diagnostic testing – ultrasound and electroneuromyography was applied to persons under study. The area of the median nerve (mm²) was assessed during the ultrasound examination. The results of the electroneuromyography study evaluated the response speed of the sensory impulse (ms), the speed of the motor impulse response (ms). Later, the tests, their sensitivity and specificity were evaluated and compared. Results. 30 patients participated in the study, of which 26 (86.7%) were women, 4 (13.3%) were men. Electroneuromyography was found to be both sensitive and specific for a measure of sensory propagation velocity, 76.2 and 75%, respectively (p = 0.042); of motor propagation speed – 100 and 75% (p = 0.040). Ultrasonography is sensitive (87.5%) but nonspecific (66.7%) (p = 0.008). The study showed that the ultrasound dimension strongly, directly and reliably correlates with the sensory impulse response rate (p < 0.001), and the ultrasound dimension moderately, directly and reliably correlates with the motor impulse response rate (p < 0.001). Conclusions. Carpal tunnel syndrome can be suspected by ultrasound measurement of the area of the median nerve, but the test is only sensitive but non-specific. Electroneuromyography can confirm the diagnosis of carpal tunnel syndrome, as the test is both sensitive and specific. Comparing the studies, a strong, direct and reliable relationship between the results of the ultrasound and the electroneuromyography testing was established. [ABSTRACT FROM AUTHOR]

Background. Today, the issues of differential diagnosis of chronic hereditary and acquired demyelinating neuropathies are still relevant. The variety of phenotypic variants of chronic inflammatory demyelinating polyradiculoneuropathy and hereditary neuropathy with liability to pressure palsies, their remitting course and the non-specificity of neurophysiological changes necessitate the identification of clear markers that can help in the differential diagnosis of the neuropathies under discussion already at the stage of the analysis of the electroneuromyographic study data.Aim. To determine neurophysiological differential diagnostic markers in the manifestation of chronic inflammatory demyelinating polyradiculoneuropathy and hereditary neuropathy with liability to pressure palsies.Materials and methods. A retrospective analysis of the data of neurophysiological examination of 25 patients with hereditary neuropathy with liability to pressure palsies and 25 patients with chronic inflammatory demyelinating polyradiculoneuropathy.Results. A combination of such indicators as the age of the onset of the disease 0.7), the value of the conduction velocity along of the motor fibers of the ulnar nerve at the level of the elbow joint 0.8), the conduction velocity along of the sensory fibers of the median nerve at the level of the wrist 0.8), absence of conduction block along the median nerve in any area, and also the presence along the ulnar nerve at the level of the elbow joint is characteristic of hereditary neuropathy with liability to pressure palsies and allows to exclude chronic inflammatory demyelinating polyradiculoneuropathy.Conclusion. Neurophysiological markers have been identified that can help in the differential diagnosis of two chronic remitting demyelinating neuropathies: chronic inflammatory demyelinating polyradiculoneuropathy and hereditary neuropathy with liability to pressure palsies. However, only a combined analysis of clinical, anamnestic and paraclinical data makes it possible to establish a final diagnosis.

Thermography and electroneuromyography parameters were studied in 34 patients with vertebrogenic pain syndrome associated with lumbar spine stenosis. All patients were treated in the neurosurgical department of the Irkutsk Scientific Centre of Surgery and Traumatology. We determined the changes in temperature values in the lumbar spine and lower extremities under the condition of disorder in peripheral nerves functional state.Purpose of the study: to evaluate the parameters of thermography and electroneuromyography in patients with lumbar spine stenosis.Materials and methods. The article presents the results of thermography and electroneuromyography of 34 patients with severe pain syndrome associated with degenerative stenosis of the lumbar part of spinal canal in preoperative period. Thermal-imaging study was carried out using a thermovision camera SVIT-004, the study of the peripheral nerves function of the lower extremities was carried out using the Neuromian-1-04 neuromyoanalyzer. The skin temperature recording points corresponded to the projection of stimulating and pickup ENMG electrodes on the spinous processes of the LIV, LV, SI vertebrae and paravertebrally.Results. Thermography parameters in patients with degenerative lumbar spine stenosis on the pain side were higher than on the intact side at all measurement points by 1–2 °C. At the same time, electroneuromyographic parameters in these patients indicated a decrease in the activity of the peripheral and central motor apparatus.Conclusion. The change in thermography parameters in patients with lumbar spine stenosis in the lumbar part and the area of pain irradiation in the lower extremities occurs alongside with the disorder of the peripheral nerves functional state.

Exercise is a major factor in the development of occupational pathology of the connective tissue and musculoskeletal system, including chronic lumbosacral radiculopathy (LSRP), which accounts for 20% of occupational diseases in Ukraine. Some problems remain insufficiently studied despite a significant number of scientific works devoted to the study of issues of etiology, pathogenesis, features of clinical manifestations, the use of diagnostic and prophylactic measures in LSRP. The criteria for diagnosing changes in the peripheral nervous system need to be clarified and systematized by in-depth study of the functional state of the nervous apparatus in patients with LSRP of professional genesis. The research was carried out in a group of 60 miners of the main professions (coal-cutter, mining worker of a clearing pit (MWCP), drifter) suffering from LSRP. The activity of the neuromuscular apparatus was assessed according to the indices of electroneuromyography (ENMG), namely: the amplitude of the M-response during stimulation at the distal point of the right and left m. Abductor Hallucis, n. Plantar Medial, S1, S2 (mV), as well as indicators of terminal and residual latencies (ms), the speed of the impulse along the indicated nerves (m/s). It was found that the average amplitude of the M-response during stimulation at the distal point m. Abductor Hallucis, n. Plantar Medial in the MWCF group was at 6.37 mV (with a reference value of 4-5.8 mV), the average pulse conduction velocity was 38.46 m/s (with a reference value of 40.00 -50.00 m/s), it was found that most often in the group of coal-cutters (64.2%), a pathological indicator of terminal latency was recorded, while in a group of drifter, it did not go beyond the normal range in one of the surveyed miners suffering from LSRP of occupational genesis. Thus, ENMG of the long nerves of the lower extremities is a useful tool of objectifying the diagnosis of LSRP of ocupational genesis, it allows to determine the degree of impairment of the functional activity of peripheral nerves, neuromuscular synapses and the contractility of the striated muscles.

Multifocal motor neuropathy is a rare motor neuron disease characterised by a progressive, gradual loss of muscle strength, although sensory functions are preserved. The worldwide frequency of this disease is estimated at 1 person per 100,000 people. MMN is diagnosed when there are characteristic clinical signs, electroneuromyography test results support the clinical findings, and other possible diagnoses are excluded. To prove the progressive course of the disease, the patient must be under long-term medical supervision, since the deteriorating state of the patient may imitate other diseases affecting the motor neuron, such as amyotrophic lateral sclerosis, chronic inflammatory demyelinating polyneuropathy, spinal muscular atrophy, and other. We present the clinical case of a 71-year-old patient who presented to the Neurology Department of the Hospital of Lithuanian University of Health Sciences Kauno Klinikos. She complained of pain in her right hip and progressing weakness of the right foot which had lasted for a year. After laboratory tests, long-term supervision, and exclusion of other diagnoses, the patient was diagnosed with an atypical type of multifocal motor neuropathy responsive to treatment with intravenous immunoglobulin.

Introduction: Mutations in the neurofilament polypeptide light chain (NEFL) gene account for <1% of all forms of Charcot-Marie-Tooth (CMT) diseases and present with different phenotypes, including demyelinating, axonal and intermediate neuropathies, and with diverse pattern of transmission, with dominant and recessive inheritance being described. Methods: Here, we present clinical and molecular data in two new unrelated Italian families, affected with CMT. Results: We studied fifteen subjects (11 women, 4 men), age range 23–62 year. Onset of symptoms was mainly in childhood, with running/walking difficulties; some patients were pauci-asymptomatic; almost all shared variably distributed features of absent/reduced deep tendon reflexes, impaired gait, reduced sensation, and distal weakness in the legs. Skeletal deformities were seldom documented and were of mild degree. Additional features included sensorineural hearing loss in 3 patients, underactive bladder in 2 patients, and cardiac conduction abnormalities, requiring pacemaker implantation, in one child. Central nervous system (CNS) impairment was not documented in any subject. Neurophysiological investigation disclosed feature suggestive of demyelinating sensory-motor polyneuropathy in one family and resembling an intermediate form in the other. Multigene panel analysis of all known CMT genes revealed two heterozygous variants in NEFL: p.E488K and p.P440L. While the latter change segregated with the phenotype, the p.E488K variant appeared to act as a modifier factor being associated with axonal nerve damage. Conclusions: CMT related to P440L mutation in NEFL is associated with a mild, childhood-onset phenotype, showing prevalently sensory distal limbs involving and with motor impairment predominantly involving anterolateral leg muscles, in the absence of CNS involvement. Additional findings, never reported so far in patients with NEFL mutation, are cardiological and urinary dysfunctions. Our study expands the array of clinical features associated with NEFL-related CMT. [ABSTRACT FROM AUTHOR]

Juvenile amyotrophic lateral sclerosis (ALS) presents a group of few rare monogenic disorders with onset from early childhood up to 25 years and much more benign course than “classic” ALS. Autosomal dominant ALS type 4 (ALS4) related to SETX gene is one of them. In spite of characteristic combined involvement of central and peripheral motor neurons, ALS4 clinical diagnostics may be difficult, particularly in atypical and/or non‑familial cases and electroneuromyography underestimation. Massive parallel sequencing permits diagnosing majority of cases and performing genetic counselling in families.Aim of this work: to describe non‑familial ALS4 case detected by whole‑exome sequencing and present a review on poorly known disorder.A 21‑year‑old female patient in a consanguineous family was examined; methods: clinical, genealogical, electroneuromyography, peripheral nerves ultrasound; molecular: panel and whole‑exome sequencing, bioinformatical analysis.The girl is an only child and an only patient in a family of Mountain Jews – first cousins. She had spastic paraparesis since age of independent walking (1.5 y.o.) and early feet deformation, her first diagnosis was cerebral palsy. In 12 years spasticity progressed, walking was lost. After orthopedic surgery in 15 years supported walking restored, at that age leg distal amyotrophy developed with no further progressing. Due to electroneuromyography results polyneuropathy was misdiagnosed. In 21 years repeated electroneuromyography excluded polyneuropathy and detected generalized motor neuron impairment and juvenile ALS was suggested. On neurological examination pronounced spastic paraparesis together with peripheral leg paraparesis without sensory impairment were detected; her supported gait was of mixed spastic and paretic types; there were no fasciculations or fibrillations.Whole‑exome sequencing detected a novel heterozygous missense mutation c.4442A>G (p.Lys1481Arg) in SETX exon 10. Sanger familial sequencing was not possible, but DNA finding matching the phenotype supported ALS4 diagnosis. Juvenile ALS4 (SETX gene) is a relatively benign autosomal dominant disease, imitating in different stages other nervous disorders of early and young age; genealogy is not always informative. Along with typical cases (like our patient) clinical variability exists. Electroneuromyography is the main instrumental tool. Methods of massive parallel sequencing are optimal in DNA testing of juvenile ALS.

Relevance. Currently, one of the most informative specific methods for diagnosing damage to the spinal cord and peripheral nervous system is electroneuromyography. This complex electrophysiological method is based on the registration, analysis and evaluation of the obtained potentials that arise during the work of the studied skeletal muscles of the patient during the passage of impulses along the peripheral nerve fibers. A feature of this method is the variety of parameters obtained: from the characteristics of the evoked potential itself – its latent period, shape, amplitude and duration, to obtaining the number of functioning motor units of the muscle fiber, the speed of the impulse of both motor and sensory innervation.The purpose of study. To analyze the current understanding of the possibilities of using the electroneuromyography method in clinical practice.Materials and methods. In the course of this study, an analysis was made of foreign and domestic literature of recent years on the possibility of using the method of electroneuromyography in adult and pediatric neurological practice.Results. The rapid development of electroneuromyography in recent years makes it possible to use two main areas: stimulation electroneuromyography (ENMG) and needle, which is currently mainly used abroad. ENMG is a method that does not require invasive intervention, which allows you to assess the state of the studied nerve in different areas, giving an understanding of the nature of the nerve lesion, as well as the degree of its damage. At the moment, there are clear indications for the use of this particular method in clinical practice, namely for polyneuropathies of any genesis, plexopathies, neuropathies and neuritis of any genesis, neural amyotrophies, tunnel syndromes, myasthenia gravis and osteochondrosis of the spine with radicular syndrome. In turn, needle electroneuromyography is an invasive method, but more accurate and highly informative, allowing to assess the functional state of the peripheral neuromotor apparatus. At the same time, this method allows you to identify the disease at an early stage of development, the localization of the pathology, the nature and degree of activity, as well as to indicate the degree of damage to the muscle fiber and the possibility of its further recovery. It is recommended to use this method as a specific diagnosis of amyotrophic lateral sclerosis, spinal amyotrophy, myotonia, myopathy of various origins, hereditary muscle diseases, paraneoplastic myopathies, and so on.Conclusion. The possibilities of using electroneuromyography currently continue to expand due to the popularity of the method as a diagnostic of the state of the neuromuscular system due to the specificity of indicators, the possibility of diagnosing many diseases at the subclinical stage, the ease of monitoring parameters in dynamics, the possibility of non-invasive use and an accurate assessment of the effectiveness of therapy.

We examined 38 patients (35 women and 3 men aged 30–40 years) with stage 2 and 3 hallux valgus in the department of traumatology and orthopedics of the Irkutsk Scientific Centre of Surgery and Traumatology to study the electroneuromyographic parameters during stimulation of the peripheral nerves of the lower extremities. All patients underwent electroneuromyographic study of peripheral nerves (n. tibialis and n. peroneus) to clarify the nature of their injuries. In 10 patients, the parameters of the monosynaptic H-reflex were additionally studied. Analysis of electroneuromyographic parameters in patients with hallux valgus demonstrated a deterioration in the peripheral nerves functioning, which was more pronounced for the tibial nerve (n. tibialis). At the same time, the parameters of the monosynaptic H-reflex obtained in patients with hallux valgus indicate the presence of a neurological deficit observed in the compression of the L5–S1 roots of the spinal cord in lumbar osteochondrosis. The results of the study suggest the presence of a single pathogenetic mechanism for the development of degenerative processes in the spinal joints (osteochondrosis) and limbs (deforming osteoarthrosis of large and small joints).

A 23-year-old previously healthy male was referred to the clinical neurophysiology unit due to a relatively fast-onset paralysis of muscles of the anterior right leg. Electroneuromyography (ENMG) revealed a total denervation of the muscles innervated by the deep peroneal nerve, diminished sensory response of the superficial peroneal nerve, and partial denervation of the peroneus longus muscle. Ultrasound and magnetic resonance imaging (MRI) revealed a large fluid collection inside the common peroneal nerve, primarily suspected to be an intraneural ganglion cyst. The cyst was surgically excised, and the function of the muscles innervated by the peroneal nerve was recovering at the control ENMG 6 months later. We describe a case of a large intraneural ganglion cyst of the peroneal nerve in an otherwise healthy young male, diagnosis by ENMG, ultrasound, and MRI, as well as subsequent operative treatment. This report demonstrates the utility of nerve ultrasound in differentiating between different causes of peroneal nerve dysfunction.

The aim of our article is to shed light on the problem of the development of Guillain-Barre syndrome after COVID-19 infection Materials and methods The main research methods we used were scientific research and the actual description of our own clinical case. Laboratory research methods, magnetic resonance imaging, and electromyography were used to confirm the diagnosis and perform differential diagnostics. Results. In 2021, the Center for Acute Neurology and Pain Treatment treated 12 patients with Guillain-Barre syndrome. Guillain-Barre syndrome (GBS) is an acute autoimmune inflammatory polyradiculoneuropathy. The clinical picture of GBS includes progressive motor and sensory disorders in the extremities and pain. We bring to your attention a clinical case of GBS in patient B., who was treated at the clinical hospital "Feofania". Patient B., 32 years old, was hospitalized in the Feofania Clinical Hospital with complaints of weakness in her arms and legs, inability to walk, foreign body sensation in the throat, difficulty swallowing, chest discomfort, and difficulty breathing. A few weeks before the disease, the patient was treated for a mild SARS-CoV-2 infection. The patient's condition gradually deteriorated by day 25 of the disease, despite plasmapheresis, intravenous immunoglobulin and glucocorticoid therapy. However, from day 29, the condition gradually improved and on re-examination after 2 months, the patient remained mild distal paresis of the leg muscles (up to 4 points), decreased tendon reflexes from the lower extremities. Disorders of sensitivity and function of the pelvic organs were not observed. Conclusion. In our article, we present a case of COVID-19-associated GBS with a classic clinical picture, increased peripheral paresis, stabilization, and gradual recovery of all functions (respiration, pelvic function, motor, sensory, and reflex) through pathogenetic treatment and follow-up rehabilitation measures.

Introduction. Examination of the dental status of children with cerebral palsy (CP) is indicative of a high occurrence and intensity of lesions of the hard dental and periodontal tissues. One of the leading etiopathogenic factors promoting the development of major dental diseases among these children is an unsatisfactory oral hygiene. Objective: to design a mathematical model to predict the state of oral hygiene in children suffering from CP with various degrees of severity of the underlying disease. Materials and methods. 122 children (average age 8.8±3.7 years) with spastic forms of CP were examined. The state of oral hygiene and intensity of dental caries were determined in all children. Electoneuromyography (ENMG) was conducted for all of them with CP, by means of stimulation methods. Results and discussion. Stomatological examination of children demonstrated a certain tendency of caries intensity increase and deterioration of oral hygiene with increasing the degree of motor function impairments. ENMG examination of patients with CP found neurophysiological signs of supra-segmental disorders, correlated with the degree of motor function impairments. The mathematical model was developed on the basis of the data obtained, enabling to prognosticate the degree of oral hygiene depending on ENMG parameters. Conclusions. The mathematical prognostic model developed enables to prognosticate oral hygiene state in every particular case, on the basis of ENMG examination carried out in the neurological department during general medical examination of children, thus laying the bases for differential indication of preventive measures and optimal direction of appropriate recommendations for both parents and children. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physical Medicine & Rehabilitation Sciences is the property of Turkiye Klinikleri and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Modern electrodiagnostics (ED) and ultrasound examination of the neuromuscular system dictates the need to use unified terminology in order to avoid inter-expert variability in describing the results of the study and drawing up a conclusion in accordance with international criteria. The results of a survey of clinical electromyography specialists and the methodology of translation of the latest version of the English-language glossary on electrodiagnostic medicine are presented.The purpose of the publication is to popularize the use of modern nomenclature among the professional community. An anonymous survey was conducted on the use of the most common terms ED. The translation of the latest English-language version of the glossary on ED and ultrasound examination of the neuromuscular system was carried out, followed by editing and discussion by an expert group. 236 people from 68 cities of Russia and neighboring countries took part in the survey. The survey results demonstrated maximum disunity, as well as conservatism in the use of terms. The nomenclature of ED terms was first compiled in 1980 by the American Association of Electromyography and Electrodiagnostics and subsequently regularly revised and supplemented in accordance with new data. The unification of terms is necessary for the standardization of conclusions, multicenter research and scientific publications.

Multifocal motor neuropathy is a rare motor neuron disease characterised by a progressive, gradual loss of muscle strength, although sensory functions are preserved. The worldwide frequency of this disease is estimated at 1 person per 100,000 people. MMN is diagnosed when there are characteristic clinical signs, electroneuromyography test results support the clinical findings, and other possible diagnoses are excluded. To prove the progressive course of the disease, the patient must be under long-term medical supervision, since the deteriorating state of the patient may imitate other diseases affecting the motor neuron, such as amyotrophic lateral sclerosis, chronic inflammatory demyelinating polyneuropathy, spinal muscular atrophy, and other. We present the clinical case of a 71-year-old patient who presented to the Neurology Department of the Hospital of Lithuanian University of Health Sciences Kauno Klinikos. She complained of pain in her right hip and progressing weakness of the right foot which had lasted for a year. After laboratory tests, long-term supervision, and exclusion of other diagnoses, the patient was diagnosed with an atypical type of multifocal motor neuropathy responsive to treatment with intravenous immunoglobulin. [ABSTRACT FROM AUTHOR]

Copyright of Medical Perspectives / Medičnì Perspektivi is the property of Dnipropetrovsk Medical Academy of Health Ministry of Ukraine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background/aim: In this study, we evaluate sciatic nerve injuries due to intramuscular injections, which is an important medicolegal problem frequently encountered in medical practice, with an extended experimental rat model of peripheral nerve injury. Materials and methods: A total of 78 male Wistar albino rats were divided into five main groups, including a control group, a sham saline group, and groups that received benzathine penicillin G, diclofenac sodium, and dexamethasone, respectively. These pharmaceutical agents were applied to the sciatic nerves of all rats after exploration in the epineurial, endoneurial, and intrafascicular compartments, excluding the control group. Outcomes were evaluated for all rats and their sciatic nerves according to functional, electrophysiological, and histopathological results. Results: Injuries were most evident in the groups that received penicillin G and diclofenac sodium, and this finding was statistically significant. It was also found that endoneurial and intrafascicular injections may cause more harm than epineurial injections. Conclusion: We have demonstrated that any medical injections applied to the epineurial, endoneurial, or intrafascicular compartments of the sciatic nerve may cause functional and electrophysiological loss with or without deterioration of the peripheral nerve architecture. [ABSTRACT FROM AUTHOR]

Introduction Neuropathic pain is a common and disabling late complication of leprosy. We investigated the clinical and electrophysiological characteristics of neuropathic pain in leprosy patients by evaluating nerve conduction, sympathetic skin response (SSR) and A-waves. Methods Twenty one leprosy patients with neuropathic pain validated by the Douleur Neuropathique en 4 (DN4)Questionnaire were selected for study. Pain intensity was measured by the visual analog scale. Demographic and clinical data were collected for all patients. Clinical data included appraisal of the median, ulnar, radial, tibial and common peroneal nerves, assessment of the sympathetic skin response and conventional electrophysiological recordings. Results Among all electroneuromyographic presentations, multifocal mononeuropathy was still the most prevalent. Sensory loss was observed more frequently than motor deficits. As most patients presented advanced clinical forms of leprosy and were under treatment, this high mean was found and the ulnar nerve was most frequently affected. The sympathetic skin response was absent in 16 patients. Higher DN4 Questionnaire scores were observed in women and in those receiving corticosteroid therapy. These inferences are possible to be made, but our study's limitations don't allow us to be certain about it. The statistical significance found only permits us to evidence what we related on the textual part of the study. Limitations The small number of patients studied, the lack of sophisticated diagnostic methods for leprosy, as well as the difficulties in assessing nerve conduction were the main limitations of this study. Conclusion The neurophysiological and clinical findings in leprous neuropathy were modest despite the conspicuous neuropathic pain. Although electrophysiological studies are a vital tool to verify nerve damage, variations in the clinical presentation of leprosy neuropathic pain render the diagnosis challenging. Further studies are needed to describe the neurophysiological evolution of this disease. [ABSTRACT FROM AUTHOR]

Copyright of Ege Journal of Medicine is the property of Ege University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background. The study of the sensitive portion of the medial plantar nerve is relevant not only in the examination of patients with tibial nerve mononeuropathy or its branches, but also in the diagnosis of polyneuropathies.Objective: to analyze the normative parameters of the sensory potential recorded during the study of the medial plantar nerve by the orthodromic method in healthy adults.Materials and methods. 126 sensitive fibers of the medial plantar nerves were studied on the Dantec Keypoint G4 device (Denmark) in 63 healthy individuals (31 men and 32 women; age from 20 to 80 years). 3 groups were identified taking into account age: group 1 included healthy people aged 20 to 39 years (n = 23); group 2 consisted of people aged 40 to 60 years (n = 20); and 3 – older than 60 years (n = 20). The parameters of the sensory potential of the medial plantar nerve are analyzed.Results. The sensory potential in the study of the sensitive portion of the medial plantar nerve was registered in all 126 healthy subjects. Comparative statistical analysis did not demonstrate significant differences between groups 1–3 in the values of such parameters of the sensory potential as the latency of the onset, the duration of the negative phase and the rate of propagation of excitation. At the same time, in groups 2 and 3, the magnitude of the amplitude from peak to peak of the sensory potential was significantly lower compared to group 1, and averaged 8.92 and 7.86 MV, respectively.Conclusion. Knowledge of the regulatory parameters will allow expanding the use of electroneuromyography of the sensitive portion of the medial plantar nerve in clinical and research practice.

Objective: The aim of the study was to compare the effectiveness of radial extracorporeal shock wave therapy and local corticosteroid injection on pain, function, and nerve conduction studies in the treatment of idiopathic carpal tunnel syndrome. Design: A total of 72 patients who were diagnosed as having carpal tunnel syndrome were included in the study. The radial extracorporeal shock wave therapy group received radial extracorporeal shock wave therapy, the local corticosteroid injection group received local corticosteroid injection, and the control group only used a resting hand splint. The patients were evaluated using a Visual Analog Scale–pain, a Visual Analog Scale–numbness, the Boston Symptom Severity Scale, the Boston Functional Status Scale, and handgrip strength tests before treatment 1 and 12 wks after the treatment. Results: Both clinical and nerve conduction study parameters improved with all three groups, and this effect continued at the 12th-week follow-up of the patients. The Visual Analog Scale–pain, Visual Analog Scale–numbness, Boston Symptom Severity Scale, and Boston Functional Status Scale scores in the first week after the treatment, as well as Visual Analog Scale–pain and Boston Functional Status Scale scores in the 12th week after the treatment, were significantly lower in the local corticosteroid injection group compared with the other two groups. Conclusions: Our study revealed the success of radial extracorporeal shock wave therapy, splint, and local corticosteroid injection, but symptom relief was greater in the first week and 12th week with local corticosteroid injection. [ABSTRACT FROM AUTHOR]

As is supposed, dysfunction of the autonomic nervous system may be involved in the pathogenesis of myasthenia gravis (MG). Disorders of the pupillomotor, orthostatic, vasomotor, and gastrointestinal systems may cause symptoms in MG. Among such symptoms, dysphagia has not yet been reported. However, this phenomenon can be a frequent symptom in patients with MG. We have examined 19 patients with class 1–2b MG (by classification of the Myasthenia Gravis Foundation of America) and 19 healthy volunteers. The existence and severity of dysphagia were characterized using clinical screening tests, manometry and endoscopy, electroneuromyography, and electrocardiography. Significant differences were found between groups of patients with dysphagia and with normal swallowing in Eat-10 and fiberoptic endoscopic evaluation of swallowing scores (P=0.001 in both cases). Between these groups, there were also significant differences in the active standing test and sympathetic skin response latencies in the foot (P=0.009 and P=0.033 respectively). In MG patients with dysphagia, this cannot solely be attributed to the parasympathetic system; sympathetic dysfunction was also found to be associated with increased dysphagia severity. It is concluded that the swallowing function should be evaluated in MG with or without dysphagia symptoms, especially in terms of esophageal phase dysfunction. [ABSTRACT FROM AUTHOR]