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Aim of the Study: In two previous studies, we found that the compound muscle action potential (CMAP) amplitude loss was significantly higher than the loss of estimated motor unit numbers in the course of Wallerian degeneration (WD). In order to overcome some drawbacks of the method previously used, we performed a similar CMAP vs MUNE comparison by using the statistical motor unit number estimation (MUNE) method., Patients and Methods: Initial electrophysiological studies on 6 patients were performed between 22 and 98 hours after the injuries; it was possible to make repeated examinations, four times in 1 nerve, twice in 1 nerve and three times in 4 nerves, before the eventual complete disappearance of the CMAPs., Results: The transected/intact (T/I) side CMAP ratios declined steeply as WD evolved. They were significantly lower than the relatively stable MUNE ratios 48 hours after the injury., Conclusion: This study, performed with the use of statistical MUNE, strengthens our previous observation by the incremental method that might have some relevance to the pathophysiology of early WD. CMAP amplitude loss that is more than expected from the amount of axonal degeneration may indicate a considerable amount of inactive muscle fibers in the motor units innervated by the nerve fibers, which are undergoing degeneration but still retain their excitability. Although technical sources of error cannot be totally excluded, our findings could more likely be explained by the failing of neuromuscular synapses in an asynchronous order before complete unresponsiveness of the motor unit ensues., (Copyright © 2014 Elsevier Masson SAS. All rights reserved.)

Objectives: None of the classifications of psychogenic non-epileptic seizures (PNES) have been widely accepted and used by physicians so far. In this study we aimed at classifying PNES on the basis of a modified version of semiological seizure classification (SSC). We also sought to assess the interrater reliability (IRR) of the PNES diagnosis based on SSC., Methods: We classified PNES into four types on the basis of our modification of SSC: pseudoaura, dialeptic, motor, and special (atonic, astatic, hypotonic) spells. Pseudoauras were not included in the statistical analysis. Ninety-one PNES attacks were observed during the 55 video-EEG sessions recorded for all patients. The interrater agreement was assessed by the kappa coefficient., Results: Twenty-nine women (78·3%) and eight men (21·6%) were surveyed, with a mean age of 28·4 ± 9·6 (range 16-54). The final diagnosis of PNES was established after a mean of 4·5 ± 2·3 years following the onset of PNES attacks in the patients. The mean seizure duration in the PNES was 241 seconds and 40·5% of our patients had PNES longer than 300 seconds. Motor and special PNES were the most common types observed by all the raters. The kappa values for each pair were as follows: Observers I-II 0·51 (p = 0·000), Observers I-III 0·47 (p = 0·000), and Observers II-III 0·73 (p = 0·000)., Conclusions: Interobserver agreement was moderate and substantial for three observers who classified PNES according to our modified SSC. The modified version of SSC could be used without difficulty in classifying PNES. Using SSC for PNES both shortens the period before diagnosis and eliminates the need to learn another new and acceptable classification for PNES.