摘要:

AbstractA brief history of the evolution of radiculopathy as a clinical entity, and the use of electrodiagnostic studies to diagnose it, are provided. Root anatomy and the concept of myotomes and dermatomes are reviewed, as is the pathophysiology of radiculopathy. The value and limitations of the various electrophysiologic procedures used in the diagnosis of radiculopathies are discussed, including motor and sensory nerve conduction studies, late responses, somatosensory evoked potentials, nerve root stimulation, and the needle electrode examination. The specific muscles are enumerated which most often appear abnormal on needle electromyography with lesions of the various roots. The electrodiagnostic differentiation of root lesions from plexus lesions is described, and the various electrodiagnostic findings with lumbar canal stenosis are discussed. Finally, the value and limitations of the electrodiagnostic assessment in the evaluation of patients with suspected radiculopathies are reviewed.

ISSN:0148-639X    

DOI:10.1002/mus.880111102

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractThe possibility of a topographic relationship between the spinal cord and the longitudinal axis of a muscle has been explored in two mammalian hamstring muscles: the rat semitendinosus (ST) and biceps femoris (BF). In both muscles the fibers did not extend the full length of the respective muscles but were arranged in longitudinal arrays. There were two such arrays in BF and three in ST; monopolar recordings revealed that each array had a transverse band of endplates extending across the middle part. By stimulating ventral nerve roots in the lumbosacral outflow, it was found that L5 made the greatest contribution to the innervation of both ST or BF was there any evidence of a topographic relationship between the spinal cord and the muscle belly.

ISSN:0148-639X    

DOI:10.1002/mus.880111103

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractBrief repetitive trains of supramaximal nerve stimulation produce intermittent muscle activation and, in time, a progressive decline in force (i.e., neuromuscular fatigue) and depression of the electromyogram (EMG). These changes may include within‐train reductions in EMG due to a failure of neuromuscular propagation.13The aim of the present study was to investigate changes in EMG during a 360‐second stimulus regimen designed to fatigue soleus and extensor digitorum longus muscles of anesthetized rats by activating the muscle with repetitive trains of 40 Hz stimuli. Measurements included peak force for each tetanus, variation of the within‐train EMG (coefficient of variation for area), and magnitude of the first EMG waveform (area) of each train. Fatigue was characterized as the relative decline in force over the course of the test. The responses of the test muscles were categorized, based on an absolute scale of fatigability, into five groups: potentiated, nonfatigable, low fatigability, intermediate fatigability, and high fatigability. Fatigable muscles (low, intermediate, and high fatigability groups) demonstrated a decreased EMG magnitude and an increased EMG‐area variation with repetitive activation. This increased variation, however, was nonmonotonically related to fatigability such that the leastandmost fatigable muscles had the smallest within‐train EMG variation. We suggest that these data can be explained by considering the EMG (compound muscle action potential) as a stochastic process that represents a composite of single‐fiber events (axonal to sarcolemmal transmission) with variable pro

ISSN:0148-639X    

DOI:10.1002/mus.880111104

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractAntibodies in individual patients with the Lambert–Eaton myasthenic syndrome (LES) differ in their reactivity with mouse motor nerve terminals. Of 26 LES patients' sera injected a single time into mice, 3 caused a highly significant reduction in stimulus‐dependent quantal release (m) of acetylcholine (ACh) (to 6, 33, and 42 quanta per impulse at 1 Hz, respectively; mean for 10 control sera, 100 quanta at 1 Hz). The most potent serum (LES‐A) was fully effective in mice deficient in complement component C5 and in mice depleted of complement components C3→C9 by cobra venom factor. A single i.v. injection of serum reducedmin direct proportion to log dose. Responses to K+depolarization and increasing concentrations of Ca2+were like those observed in human LES.With LES‐A serum, or its IgG,mwas reduced near maximally in 1 day and plateaued in 3–4 days. Recovery began after day 8;mwas in the normal range by day 20–30. Electromyographic (EMG) abnormalities were not seen untilmfell below 40 quanta per impulse at 1 Hz. Below 10 quanta, clinical signs of weakness appeared, and the EMG abnormalities were those classically associated with LES: a marked reduction of compound muscle action potential to a single nerve stimulus in rested muscle, a further decrement during stimulation at slow rates, but marked facilitation during rapid repetitiv

ISSN:0148-639X    

DOI:10.1002/mus.880111105

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractA middle‐aged male developed a right posterior femoral cutaneous neuralgia that persisted for 10 years without any associated neurologic, electrophysiologic, or radiologic findings. Five years after onset, surgical exploration of the subgluteal area identified a venous malformation surrounding the nerve. The syndrome appears unique and exemplifies all major aspects of the sensory distribution of the nerve comple

ISSN:0148-639X    

DOI:10.1002/mus.880111106

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractA cross‐sectional study of 471 randomly selected employees from 4 industries was performed to assess the prevalence of slowing of sensory conduction of the median nerve at the carpal tunnel as well as the effect of age and sex on slowing. The association between slowed conduction and symptoms of carpal tunnel syndrome (CTS) was also evaluated. Slowing was identified in 17% of the subjects and in 11% of the hands. The prevalence and the severity of slowing increased with increasing age of the subjects. Slowed conduction occurred more often among the women in the study, but this was shown to be an effect of age and not of sex. Slowing occurred six times more often in hands with symptoms of CTS than in those not reporting symptom

ISSN:0148-639X    

DOI:10.1002/mus.880111107

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractA large CMT family with 5 affected males and 10 affected females of 37 members in four generations was investigated by recombinant DNA studies. The proband patient in his original desscription of the pedigree indicated male‐to‐ male transmission in one of his relatives, suggesting autosomal dominant inheritance. The genetic linkage study between the CMT locus and the loci of six markers mapped on chromosome 1 (FY, APCS, AT3, REN, APOA2, and GBA) gave negative results. These findings prompted further pedigree investigation which proved that male‐to‐male transmission was not present. A genetic linkage study with DXYS1, which is a DNA marker mapped on the long arm of the chromosome X, revealed tight linkage with ẑ = 3.15 at

ISSN:0148-639X    

DOI:10.1002/mus.880111108

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractA study was undertaken, using methods of stabilometry to compare stability of stance in normal children (n= 37) and those with Duchenne muscular dystrophy (n= 61). The purpose of this study was to monitor changes in the locus of the center of gravity and the range and frequency of sway and to evaluate the effect of orthotic application in an attempt to obtain information that would assist further development of orthoses.In group 1, boys with Duchenne muscular dystrophy who were still walking without assistance (mean age 7.2 ± 1.76 years), the analysis of sway showed that, between 5 and 6 years of age, the boys already had ranges of anteroposterior (A/P) and lateral (Lat) sway that were significantly greater than those found in normal children (A/PP<0.05, LatP<0.01). In group 2, boys with Duchenne muscular dystrophy when orthoses had been introduced (n= 23, mean age 10.4 ± 1.47 years), the center of gravity was returned to a more normal position. There was a reduction of the antero‐posterior range of sway, but the lateral range of sway remained significantly greater (P<0.01) as did the frequency of sway in both the anteroposterior and lateral directions (A/PP<0.001, LatP<0.0

ISSN:0148-639X    

DOI:10.1002/mus.880111109

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractA double‐blind controlled trial of penicillamine and vitamin E against placebo was conducted in 106 boys with Duchenne muscular dystrophy. Nine dropped out of the study after being randomized. Patients were evaluated using an established protocol that measures muscle strength, joint contractures, functional grade, and pulmonary function. The trial lasted for 18 months. The power of the study to detect a 75% slowing of the disease was 0.95 at aP<0.05. No therapeutic effect was observed in the patients taking penicillamine and vitamin E as compared with those taking placeb

ISSN:0148-639X    

DOI:10.1002/mus.880111110

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY

摘要:

AbstractIgM monoclonal antibodies present in the sera from some patients with peripheral neuropathy react with an antigenic carbohydrate determinant that is present on the myelin‐associated glycoprotein (MAG) and other peripheral nerve glycoproteins and glycolipids. It is generally believed that the neuropathy in these patients may be caused by antibody‐ mediated nerve damage. Intraneural injection of serum from patients with this disease produced an extensive inflammatory, macrophage‐mediated demyelination of feline peripheral nerve. This only occurred with very fresh sera which had been supplemented with additional complement. Injection of sera from normal subjects failed to produce any demyelination. These results are in accordance with a recent study by Hays et al.13and contradict earlier negative reports of similar studies. It is important to note that the pathology observed in these experimental studies bears little resemblance to that seen in the human neuropathy, and caution must therefore be exercised when interpreting this data in relation to the pathogenic mechanisms that might operate in the human di

ISSN:0148-639X    

DOI:10.1002/mus.880111111

出版商:Wiley Subscription Services, Inc., A Wiley Company    

年代:1988

数据来源: WILEY