- Email: [email protected]
111. Nerve conduction study on the patient with carpal tunnel syndrome coexisting with cervical spondylotic myelopathy – A case report
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Society Proceedings / Clinical Neurophysiology 120 (2009) e147–e180
they could increase early BP amplitude during negative NFB performance. Purpose: We investigated the effects of self-regulation of SCPs on BP amplitude in patients with PD. Patients and methods: In 7 patients with PD aged between 36 and 71 years, 5 electrodes were fixed on the scalp (C3, C1, Cz, C2 and C4). BP was firstly recorded for self-paced, button-press by the right thumb about every 10 s (BP1). It was followed by NFB training when subjects trained himself for self-regulation of SCPs at Cz for 20 min. The 2nd BP was recorded during negative NFB performance (BP2). The whole set was done in one day and was repeated 2–3 times. BP1 and BP2 were compared in the two groups of NFB performance (good trials vs. poor trials). Result: Good trial sessions had larger BP2 than BP1 whereas poor sessions had smaller BP2 than BP1. Conclusion: It was most likely that good negative NFB performance could increase EPSP of pyramidal cells for early BP generation in patients with PD. doi:10.1016/j.clinph.2009.02.115
110. Hearing screening in children by distortion product otoacoustic emission (DPOAE)—Mamiko Yasuda (Toho University School of Medicine, Tokyo, Japan) Otoacoustic emission (OAE) was reported by David Kemp in 1978, that has been considered to be related to the amplification function of the cochlea. Distortion product otoacoustic emission (DPOAE) is generated in the cochlea responding to two tones (f1, f2. f1:f2 = 1:1.2) of a given frequency and sound pressure level presented in the external auditory canal. DPOAE is an objective indicator of normally functioning outer hair cells of the cochlea. DPOAE can be frequency sensitive test, so DP gram reflects in pure tone audiogram, and our study could confirm its frequency property. Because of the test is fast recording in short time (a few minutes), safe, and small cost, DPOAE is very useful for hearing screening in children. Especially, the sensitivity is almost 100% by DPOAE screener for newborn normal baby. But the middle ear and external auditory canal condition influence for DPOAE. For example, no DPOAE is seen in children suffering otitis media with effusion. Therefore ear drum have to be checked before the test by otolaryngologist. doi:10.1016/j.clinph.2009.02.116
111. Nerve conduction study on the patient with carpal tunnel syndrome coexisting with cervical spondylotic myelopathy – A case report—Kazushige Hasegawa, Daizo Sasaki, Yoshihiro Matsubara (Yonezawa City Hospital, Yonezawa City, Japan) A 70-year-old male suffered for ten months from bilateral finger numbness and gait disturbance. The following clinical findings were observed; marked left thenar atrophy, no opposition of left thumb, positive Hoffmann reflex in right side, and bilaterally increased lower deep tendon reflex. Sensory disturbance were observed in right little finger and left palmar area including thumb. Manual muscle test (MMT) showed extensor carpi radialis 5/5, extensor digitorum communis 3/5, abductor digiti minimi 3/5, first dorsal interossei 3/5, abductor pollicis brevis 4/1 [R/L]. Nerve conduction study revealed distal latency of abductor pollicis brevis 4.0 ms/NR, distal latency of second lumbrical muscle 3.8/6.0 ms, median MCV 49/44 m/s, index finger SCV 41 m/s/NR, little finger
SCV 44/48 m/s, distal latency of abductor digiti minimi 2.8/ 2.6 m/s, ulnar MCV 55/57 m/s, ulnar F-latency 28.0/28.4 ms [R/L, NR: not recordable]. Magnetic resonance images demonstrated the spinal cord compression in C5/6 and C6/7 level. C3–C6 laminoplasty improved walking ability, but left palmar symptoms were left unchanged. Eight months later, the procedure of left carpal tunnel decompression could reduce the uncomfortable symptoms in left palmar area. doi:10.1016/j.clinph.2009.02.117
112. Severity of idiopathic carpal tunnel syndrome classified on the findings of 3 T MRI—Akinori Sakai, Toshihisa Oshige, Masahiro Suzuki, Yoshiaki Yamanaka, Toshitaka Nakamura (University of Occupational and Environmental Health, Kitakyushu, Japan) The aim of this study was to classify the severity of idiopathic carpal tunnel syndrome based on the findings of 3 T MRI. Median nerve was identified at the level of hook of hamate in the T2 weighted axial view. The subjects were 99 hands of 51 cases and 61.1 years of age on the average. The flattening of median nerve and the lower contrast ratio of median nerve for ulnar nerve were correlated with longer distal latency of motor nerve and delayed sensory nerve conduction velocity. Thus, we classified the severity into three groups of oval group, flat high group and flat low group according to the degrees of flattening and contrast ratio. This MRI classification of severity was comparable with Hamada’s clinical classification. In conclusion, we could classify the severity of idiopathic carpal tunnel syndrome based on the flattening and the contrast ratio of median nerve using 3 T MRI. doi:10.1016/j.clinph.2009.02.118
113. Epileptogenic fast oscillations on neonatal and infantile EEGs in hemimegalencephaly—Madoka Yamazaki 1,2, Hiroshi Otsubo 2, Masato Matsuura 1 (1 Tokyo Medical and Dental University, Tokyo, Japan, 2 The Hospital for Sick Children, Toronto, Canada) Purpose: Hemimegalencephaly is well known to be epileptic encephalopathy from neonates in most of cases. Ictal fast oscillations (FOs) are recognized on intracranial EEG and during epileptic spasms on scalp EEG. Our aims are to analyze interictal FO and EEG patterns in neonates and infants with hemimegalencephaly. Methods: We collected seven patients with total (5) and partial hemimegalencephaly (2). We retrospectively analyzed 18 EEGs (sampling rate 200 or 500 Hz) between 3 days and 24 months of age before surgery. We applied multiple band frequency analysis to analyze maximum frequency and power of FO in selected interictal periods. Results: Maximum interictal FOs ranged between 22 and 57 Hz (mean, 42 Hz) over the hemimegalencephaly side. Differences in maximum FOs remained within 1–8 Hz (mean, 3 Hz) across consecutive EEGs. We found four EEG patterns: (1) suppression-burst pattern (7 EEGs, 6 patients); (2) continuous triphasic complex pattern (5 EEGs, 3 patients); (3) continuous high-amplitude slow waves with spikes (3 EEGs, 2 patients); (4) frequent spike and slow waves (3 EEGs, 2 patients). Conclusion: We confirmed interictal epileptogenic FOs in neonatal and infantile EEGs of patients with hemimegalencephaly. The EEG
Society Proceedings / Clinical Neurophysiology 120 (2009) e147–e180
they could increase early BP amplitude during negative NFB performance. Purpose: We investigated the effects of self-regulation of SCPs on BP amplitude in patients with PD. Patients and methods: In 7 patients with PD aged between 36 and 71 years, 5 electrodes were fixed on the scalp (C3, C1, Cz, C2 and C4). BP was firstly recorded for self-paced, button-press by the right thumb about every 10 s (BP1). It was followed by NFB training when subjects trained himself for self-regulation of SCPs at Cz for 20 min. The 2nd BP was recorded during negative NFB performance (BP2). The whole set was done in one day and was repeated 2–3 times. BP1 and BP2 were compared in the two groups of NFB performance (good trials vs. poor trials). Result: Good trial sessions had larger BP2 than BP1 whereas poor sessions had smaller BP2 than BP1. Conclusion: It was most likely that good negative NFB performance could increase EPSP of pyramidal cells for early BP generation in patients with PD. doi:10.1016/j.clinph.2009.02.115
110. Hearing screening in children by distortion product otoacoustic emission (DPOAE)—Mamiko Yasuda (Toho University School of Medicine, Tokyo, Japan) Otoacoustic emission (OAE) was reported by David Kemp in 1978, that has been considered to be related to the amplification function of the cochlea. Distortion product otoacoustic emission (DPOAE) is generated in the cochlea responding to two tones (f1, f2. f1:f2 = 1:1.2) of a given frequency and sound pressure level presented in the external auditory canal. DPOAE is an objective indicator of normally functioning outer hair cells of the cochlea. DPOAE can be frequency sensitive test, so DP gram reflects in pure tone audiogram, and our study could confirm its frequency property. Because of the test is fast recording in short time (a few minutes), safe, and small cost, DPOAE is very useful for hearing screening in children. Especially, the sensitivity is almost 100% by DPOAE screener for newborn normal baby. But the middle ear and external auditory canal condition influence for DPOAE. For example, no DPOAE is seen in children suffering otitis media with effusion. Therefore ear drum have to be checked before the test by otolaryngologist. doi:10.1016/j.clinph.2009.02.116
111. Nerve conduction study on the patient with carpal tunnel syndrome coexisting with cervical spondylotic myelopathy – A case report—Kazushige Hasegawa, Daizo Sasaki, Yoshihiro Matsubara (Yonezawa City Hospital, Yonezawa City, Japan) A 70-year-old male suffered for ten months from bilateral finger numbness and gait disturbance. The following clinical findings were observed; marked left thenar atrophy, no opposition of left thumb, positive Hoffmann reflex in right side, and bilaterally increased lower deep tendon reflex. Sensory disturbance were observed in right little finger and left palmar area including thumb. Manual muscle test (MMT) showed extensor carpi radialis 5/5, extensor digitorum communis 3/5, abductor digiti minimi 3/5, first dorsal interossei 3/5, abductor pollicis brevis 4/1 [R/L]. Nerve conduction study revealed distal latency of abductor pollicis brevis 4.0 ms/NR, distal latency of second lumbrical muscle 3.8/6.0 ms, median MCV 49/44 m/s, index finger SCV 41 m/s/NR, little finger
SCV 44/48 m/s, distal latency of abductor digiti minimi 2.8/ 2.6 m/s, ulnar MCV 55/57 m/s, ulnar F-latency 28.0/28.4 ms [R/L, NR: not recordable]. Magnetic resonance images demonstrated the spinal cord compression in C5/6 and C6/7 level. C3–C6 laminoplasty improved walking ability, but left palmar symptoms were left unchanged. Eight months later, the procedure of left carpal tunnel decompression could reduce the uncomfortable symptoms in left palmar area. doi:10.1016/j.clinph.2009.02.117
112. Severity of idiopathic carpal tunnel syndrome classified on the findings of 3 T MRI—Akinori Sakai, Toshihisa Oshige, Masahiro Suzuki, Yoshiaki Yamanaka, Toshitaka Nakamura (University of Occupational and Environmental Health, Kitakyushu, Japan) The aim of this study was to classify the severity of idiopathic carpal tunnel syndrome based on the findings of 3 T MRI. Median nerve was identified at the level of hook of hamate in the T2 weighted axial view. The subjects were 99 hands of 51 cases and 61.1 years of age on the average. The flattening of median nerve and the lower contrast ratio of median nerve for ulnar nerve were correlated with longer distal latency of motor nerve and delayed sensory nerve conduction velocity. Thus, we classified the severity into three groups of oval group, flat high group and flat low group according to the degrees of flattening and contrast ratio. This MRI classification of severity was comparable with Hamada’s clinical classification. In conclusion, we could classify the severity of idiopathic carpal tunnel syndrome based on the flattening and the contrast ratio of median nerve using 3 T MRI. doi:10.1016/j.clinph.2009.02.118
113. Epileptogenic fast oscillations on neonatal and infantile EEGs in hemimegalencephaly—Madoka Yamazaki 1,2, Hiroshi Otsubo 2, Masato Matsuura 1 (1 Tokyo Medical and Dental University, Tokyo, Japan, 2 The Hospital for Sick Children, Toronto, Canada) Purpose: Hemimegalencephaly is well known to be epileptic encephalopathy from neonates in most of cases. Ictal fast oscillations (FOs) are recognized on intracranial EEG and during epileptic spasms on scalp EEG. Our aims are to analyze interictal FO and EEG patterns in neonates and infants with hemimegalencephaly. Methods: We collected seven patients with total (5) and partial hemimegalencephaly (2). We retrospectively analyzed 18 EEGs (sampling rate 200 or 500 Hz) between 3 days and 24 months of age before surgery. We applied multiple band frequency analysis to analyze maximum frequency and power of FO in selected interictal periods. Results: Maximum interictal FOs ranged between 22 and 57 Hz (mean, 42 Hz) over the hemimegalencephaly side. Differences in maximum FOs remained within 1–8 Hz (mean, 3 Hz) across consecutive EEGs. We found four EEG patterns: (1) suppression-burst pattern (7 EEGs, 6 patients); (2) continuous triphasic complex pattern (5 EEGs, 3 patients); (3) continuous high-amplitude slow waves with spikes (3 EEGs, 2 patients); (4) frequent spike and slow waves (3 EEGs, 2 patients). Conclusion: We confirmed interictal epileptogenic FOs in neonatal and infantile EEGs of patients with hemimegalencephaly. The EEG