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Abstract Background The association between carpal tunnel syndrome (CTS) and ulnar nerve entrapment is unclear, and the extra-median paresthesia in the ulnar nerve territory innervation in CTS is unexplained. Our purpose is to evaluate the neurophysiologic changes in ulnar nerve sensory fibers secondary to idiopathic CTS in comparison to normal subjects, and their relation to the severity of CTS. Results The difference between CTS and control hands regarding all parameters of ulnar motor nerve conduction studies (MNCS) was not statistically significant (p > 0.05). There was a statistically significant difference in all parameters of median sensory conduction study (SCS) and MNCS between CTS and control hands (p < 0.0001) except for conduction velocity and in all parameters of median and ulnar SCS recording digit 4 (D4) (p < 0.05). The mean value of abnormalities of ulnar SCS recording D4 and digit 5 (D5) was significantly higher in moderate and severe CTS hands (p < 0.05). There were significant negative correlations between median motor and sensory latency and ulnar sensory amplitude recording D4 and D5. Conclusion Ulnar sensory nerve abnormalities exist among CTS patients, which were more in moderate and severe grades. The drop in amplitude of ulnar nerve sensory response argues in favor of the possible impact of CTS on the ulnar nerve and did not indicate axonal deterioration of the ulnar nerve.

Introduction: Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome in the upper extremity leading to the functional disability. The consequence of the entrapment is the poor health of the nerve (conduction, mobility, and blood flow). Purpose of the Study: The aim of the study is to evaluate the effect of neural mobilization on the motor nerve conduction velocity and function in the CTS patients. Methods: Thirty CTS patients (only females) were scrutinized on the basis of the inclusion and exclusion criteria. They were randomized into two groups A (n = 15) and B (n = 15) using simple random sampling. Group A patients were treated with the conventional physiotherapy regimen and Group B were provided neural mobilization. Results: The data analysis was done using SPSS version 22. The t-test reveals that there was statistically significant improvement in posttreatment values of Group B for numeric pain rating scale, symptom severity scale, function status scale, motor nerve conduction latency, and velocity at P = 0.05. Conclusions: Neural mobilization in the CTS patients improves the motor nerve conduction and functional status. It may be incorporated in the physiotherapy treatment protocol of CTS patients. [ABSTRACT FROM AUTHOR]

ABSTRACT Introduction: We evaluated the electrodiagnostic (EDX) pattern of severe and extreme median nerve lesions at the wrist (MNLW) in patients with idiopathic carpal tunnel syndrome. Methods: EDX data were recorded in 229 patients with 314 severe and extreme MNLW and 447 patients with 777 non-severe MNLW. We recorded distal motor latency (DML) to abductor pollicis brevis (APB) and second lumbricalis (2L), sensory conduction (SC) from digits 2 and 3, and needle examination of APB. Results: Preservation rate of DML to APB and 2L and of SC from digits 2 and 3 were 100%, 100%, 85%, and 76%, respectively, for severe MNLW, and 37%, 90%, 36%, and 26% for extreme MNLW. Active denervation, as demonstrated by fibrillation potentials, was found in 1% of non-severe NMLW, 7% of severe MNLW, and 56% of extreme MNLW cases. Conclusions: In idiopathic severe and extreme MNLW, the DML to the 2L and averaged SC from digit 2 can be present when other responses are absent. Muscle Nerve 51: 201-206, 2015 [ABSTRACT FROM AUTHOR]

Objective: To evaluate the relationship among obesity, incidence of idiopathic median nerve lesion at the wrist (MNLW), idiopathic severe MNLW and diabetes mellitus type 2 (DMT2)-associated severe MNLW. Methods: Clinical and electrodiagnostic data were prospectively collected from 676 patients (≥20years, 76% females) with carpal tunnel syndrome who were referred to our electrodiagnostic laboratories. In total, 229 patients had 314 cases of severe idiopathic MNLW, 447 had 777 cases of idiopathic non-severe MNLW, and 43 DMT2 patients had 62 cases of severe MNLW. We computed the standardized prevalence ratio (SPR) for obesity and compared the prevalence of obesity and body mass index (BMI) in patients with idiopathic MNLW and the 2009 OBesity EPIdemilogic (OBEPI) sample representing the prevalence of obesity in 24,455 French adults. We compared the prevalence of obesity in DMT2 patients and the Échantillon national témoin représentatif des personnes diabétiques (ENTRED) sample representing the prevalence of cardiovascular risk factors, including obesity, in 3894 French patients with DMT2. Results: The SPR for obesity was 1.60 (95% confidence interval 1.23–2.07) for idiopathic severe MNLW as compared with the OBEPI sample, and 1.72 (1.17–2.46) for DMT2-associated severe MNLW as compared with the ENTRED sample. The risk of severe MNLW increased with BMI: the adjusted odds ratio was 1.09 (1.05–1.13) for each 1-point increase in BMI. This risk was not significant for patients 60years and older. Discussion: The prevalence of obesity is increased for patients with severe MNLW and DMT2-associated severe MNLW as compared with their respective general populations. [ABSTRACT FROM AUTHOR]

The article discusses a study which determines the association between ulnar nerve and carpal tunnel syndrome. The study has conducted measurement of ulnar nerve function among 82 carpal tunnel syndrome patients. Results reveal electrophysiological evidence of traction on ulnar nerve fibers to patients with moderate carpal tunnel sydrome.

Abstract: Aim: Genitofemoral nerve (GFN) injury may occur because of chronic pressure of hernia sac or surgical intervention. A prospective study was performed to evaluate GFN electrophysiologically in children with inguinal hernia repair. Methods: Children with inguinal hernia were evaluated for GFN electrophysiologically before and after (3-6 months postoperatively) inguinal hernia repair. Bilateral GFN motor response latencies and durations were investigated electrophysiologically by surface electrodes. Wilcoxon signed ranked test was used for statistical analysis, and P values lower than .05 was considered to be significant. Results: Eleven patients with a mean age of 4.45 ± 2.16 were enrolled in the study. Mean latency of patients was 2.37 ± 0.89 milliseconds preoperatively and 3.14 ± 1.02 milliseconds postoperatively. Latency of GFN was found prolonged after hernia repair (P = .008). Duration of GFN motor response was 9.94 ± 1.49 milliseconds and 11.18 ± 2.44 milliseconds, respectively, in preoperative and postoperative recordings. There was no significant difference detected in mean durations (P > .05). Conclusion: Latency of GFN may prolong after inguinal hernia repair. Prolongation of GFN latency may be the result of surgical injury during hernia repair and consequently also related with chronic groin pain. [Copyright &y& Elsevier]

Abstract: Objective: The cause of decreased median forearm motor conduction velocity (FMCV) in carpal tunnel syndrome (CTS) is best ascribed to retrograde axonal atrophy (RAA); however, the relationships between the occurrence of RAA and electrophysiological or clinical severity remains controversial. We attempt to determine whether RAA really occurs in CTS patients with normal median FMCV and to investigate any relationships between RAA and severity of compression at the wrist. Methods: Consecutive CTS patients were enrolled and age-matched volunteers served as controls. We performed conventional nerve conduction studies (NCS) and measured median and ulnar distal motor latencies (DML), FMCV, compound muscle action potential (CMAP) amplitudes, distal sensory latencies (DSL), and sensory nerve action potential (SNAP) amplitudes. Furthermore, palmar median stimulation was done to calculate the wrist–palm motor conduction velocity (W-P MCV). Patients included for analysis should have normal FMCV and needle examination. We compared each electrodiagnostic parameters between the patient group and controls. Results: The mean±SD of the W-P MCV for patients and controls were 33.26±6.74 and 52.14±5.85m/s and those of median FMCV were 55.26±3.56 and 57.82±3.9m/s, respectively. There was a significant reduction in the W-P MCV (36.2%, P<0.00001), significant decrease in the median FMCV (4.43%, P<0.00001) and SNAP amplitudes, and an increase of the DML and DSL in the patient group (P<0.00001) compared to the controls; however, there were no differences in median and ulnar CMAP amplitudes, ulnar FMCV and DML between the controls and patients. Conclusions: RAA and relatively slowed median FMCV do occur in CTS patients with normal median FMCV, regardless of severity of clinical manifestations and electrophysiological abnormalities. Significance: This article provides new information for research of the electrophysiological changes of the proximal nerve part at distal injury. [Copyright &y& Elsevier]

INTRODUCTION: In upper motor neuron (UMN) syndromes, F-waves are of higher amplitude, increased duration, and increased latency. Increased F-wave frequency in UMN syndromes is not well documented. We have studied the effect of corticospinal lesion on F-wave frequency, M-wave amplitude, distal motor latency and on the Neurophysiological Index (CMAP amplitude/DML × % F-wave frequency) which we have described previously in amyotrophic lateral sclerosis (ALS). METHOD: We studied 145 abductor digiti minimi (ADM) muscles in 75 patients with ALS. Six groups of hands were defined, based on strength of the ADM, as assessed clinically by the MRC scale, and the presence or absence of UMN signs in the same upper limb. RESULTS: CMAP amplitude and area were decreased, and DML increased, in weaker muscles (MRC < 3) causing a change in the ALS Neurophysiological Index. In general, UMN signs were not correlated with increased F-wave frequency. In five weak hands F-responses were studied in individual motor units. A larger number of responding motor units in these weak limbs with UMN signs was observed. CONCLUSION: F-wave excitability is largely dependent on the size of the lower motor neuron pool. [ABSTRACT FROM AUTHOR]

Copyright of Der Nervenarzt is the property of Springer Nature 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.)

Copyright of Journal of Neurology is the property of Springer Nature 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.)

Abstract: Aim: Inguinoscrotal pathologies are commonly seen in childhood. The genitofemoral nerve (GFN) is responsible for sensitive innervations of scrotal region and the motor innervations of cremasteric muscle. GFN also innervates the afferent and efferent pathways of cremasteric reflex. A prospective study was performed to evaluate the possible relation between inguinoscrotal pathologies and GFN motor functions. Methods: Patients with inguinal hernia, hydrocele, undescended or retractile testicles, aged between 2-12 years were enrolled in the study. Bilateral latency and duration of GFN motor conductions (GFNMC) were obtained electrophysiologically by surface electrodes. GFNMC recordings of non-pathological sides were assessed as control group. Latency and duration of each group were compared with control group (Mann-Whitney U test). P values lower than .05 were considered significant. Results: Seventy-three electrophysiologic evaluations were investigated in inguinal hernia (n:18), hydrocele (n:9), undescended testicle (n:14), retractile testicle (n:12) and control (n:20) groups. There was no age difference between groups and controls. Latency was significantly prolonged in inguinal hernia group when compared with control group (P = .028). Although the latencies were shortened in undescended testicle group, no significant difference detected (P > .05). Conclusion: Prolonged latencies in inguinal hernia may be a result of nerve trap caused by hernia sac. GFN motor functions showed no causative role in other inguinoscrotal pathologies. It can be also suggested that clinical features of other inguinoscrotal pathologies were not affected by GFN motor functions. Electrophysiological studies in younger age groups with large number of patients are needed to support our suggestions. [Copyright &y& Elsevier]

Introduction Neurography is a well-established routine method for the quantitative study of nerve and muscle function. It is reproducible, non-invasive and can be performed by technicians. Over time new parameters have gone from experimental to routine area based on accumulated evidences. In addition, old parameters can now be explained in light of new knowledge. Here is a short summary of some of the details around routine techniques. Methods Standard surface electrodes are used for nerve stimulation and muscle recording. Results For motor conduction studies the surprising effect of the so-called reference electrode (E1) will be exemplified from studies of some hand and leg nerves. The knowledge of the signal generators is essential for the meaningful interpretation. The presentation will also include description and possible explanation of some abnormal signals (A-waves, extra discharges, CMAP satellites) seen in pathological conditions. For sensory conduction studies, the two recording electrodes give usually a similar contribution to the recorded signal which is generated by subtraction of two signals with a slight time differences. The practical importance of technical and biological factors such as interelectrode distance, signal shape (changed in pathology), and temperature will be discussed. Conclusion The Neurography signals may be more complex than usually realized. The underlying factors that determine or at least influence the signal shape must be understood and if possible standardized, for optimal interpretation of the relation between the signal and the biological generators. [ABSTRACT FROM AUTHOR]

Neurography and EMG are complementary techniques used in the diagnosis and monitoring of neuropathies. Both assess function of the peripheral nervous system and provide clinically useful information regarding the functional status of peripheral nerves. This information is not readily obtainable using biochemical, genetic or imaging techniques. I will discuss the role of these techniques in the diagnosis and management of neuropathies and some limitations of these techniques. These methods are routinely used in an EMG lab. These are most useful when used in conjunction with clinical examination to answer a well-defined clinical question. Reference values are required for interpretation of the data., (Copyright © 2016 Elsevier Masson SAS. All rights reserved.)

The distribution of sensory symptoms in carpal tunnel syndrome is strongly dependent on the degree of electrophysiological dysfunction of the median nerve. The association between carpal tunnel syndrome and ulnar nerve entrapment is still unclear. In this study, we measured ulnar nerve function in 82 patients with carpal tunnel syndrome. The patients were divided into group I with minimal carpal tunnel syndrome (n = 35) and group II with mild to moderate carpal tunnel syndrome (n = 47) according to electrophysiological data. Sixty-one age- and sex-matched subjects without carpal tunnel syndrome were used as a control group. There were no significant differences in ulnar sensory nerve peak latencies or conduction velocities from the 4(th) and 5(th) fingers between patients with carpal tunnel syndrome and the control group. The ulnar sensory nerve action potential amplitudes from the 4(th) and 5(th) fingers were lower in patients with carpal tunnel syndrome than in the control group. The ratios of the ulnar sensory nerve action potential amplitudes from the 4(th) and 5(th) fingers were almost the same in patients with carpal tunnel syndrome as in the control group. These findings indicate that in patients with minimal to moderate carpal tunnel syndrome, there is some electrophysiological evidence of traction on the adjacent ulnar nerve fibers. The findings do not indicate axonal degeneration of the ulnar nerve.