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A study of sural nerve using conduction velocity distribution and morphometric analysis
7OP 81.
Society Central motor conduction abnormalities in spinal ischemia associated with cocaine abuse. - P. Profice, V. Di Lazzaro, D. Restuccia, R. Nardone, A. Olviero, M. Pennisi, F. Della Corte, V. Mignani, P. Tonali (Universiti Cattolica, Roma)
Although over 300 cocaine related cerebrovascular diseases have been reported after the tirst description from Harlem Hospital Center in 1977, only a few cases of spinal ischemic disorders associated with cocaine abuse have been published. We describe two cases of acute myelopathy following intravenous injection of cocaine. The clinical features suggested the involvement of the territory of the cervical anterior spinal artery in the first patient and of the lumbar anterior spinal artery in the second patient. Central nervous system MRI revealed a cervical ischemic lesion in the former and was fully normal in the latter. A motor evoked potential study demonstrated an involvement of central motor pathways for both upper and lower limbs in patient one and for lower limbs only in patient two. It is concluded that electrophysiological studies, in addition to clinical assessment, can be helpful in diagnosing ischemic myelopathy due to cocaine abuse. 82.
Multimodal evoked potentials in migraine: preliminary data. - A. Ammendola, T. Marmoloa, R. Cantore, E. Giordanoa, G. Ugolini, V. Pizzaa, C. Colncci d’Amatoa, F. Bravaccio (Chair of Nenrophysiopatohology. aService of Diagnosis and Therapy of Cephaleas, Chair of Neurology II University of Naples)
Our previous study on visual evoked potentials in a group of migraine patients showed an increase in latency and a reduction of amplitude of PlOO wave. This is a report about the research on the behavior of somatosensory evoked potentials (SEPs) and the brainstem auditory potentials (BAEPs). In an intercritical phase, 20 migraine patients and a control group of 20 patients of the same age have been examined. The diagnosis has been made according to the ‘International Headache Society’ criteria. The SEPs by stimulation of median nerve and the brainstem auditory potentials have been studied. In comparison with the control group, the migraine patients SEPs show a decrease in latency and an increase in the amplitude of the N20 wave, while the BAEPs reveal an increase in the latency of the V wave and a decrease in the amplitude expressed by the ratio V wave/l wave. The resulting data, which are very difficult to interpret, could indicate the presence of central nervous system disorders in migraine patients, and, within these disorders, the involvement of various sensory systems. 83.
Longitudinal nenrophysiological study in asymptomatic hiv seropositive subjects. - P. Gambaro, M. Mauri, P. Bertora, P. Meravigliaa, A. Mangoni (Departments of Neurology. a2nd Infections Diseases, ‘L.Sacco’ Hospital, Milan, Italy)
The aim of this study was to evaluate early nervous system changes in neurologically asymptomatic HIV positive patients by multimodal evoked potentials (VEPs, BAEPs, P300, median and tibia1 nerves SSEPs). We selected 30 subjects (19 men, 1 I women, mean age 31.5 years) at CDC II, III, IVC2 and IVE stages without neurological symptoms. We present the results of baseline visits and follow-up: the data of 25 subjects at first control, 12 and 8 at the second and third are at present available. Data were analyzed by Student’s t test. VEPs, BAEPs and P300 results were normal. Median nerve SSEPs showed a prolonged N9-N13 difference (P < 0.05) at 6 and 12 months follow-up and a reduction in N20 wave amplitude (P < 0.005) at 12 and 18 months follow-up. Tibia1 nerve SSEPs showed a prolonged latency of P40 wave (P < 0.02) and an increase of CCT (P < 0.01) at 6 and 12 months follow-up. 84.
A study of snral nerve using conduction velocity distribution and morphometrlc analysis. - P. Valla, M. Osio, S. Iannaconea, M.R. Caccia, A. Qnattrinia, A. Salvaggiob, A. Mangoni
Proceedings (I Clinica Neurologica. aIV Igiene e Medicina Preventiva,
Clinica Nenrologica. Universite di Milano)
bIstitnto
di
In the present study the sensory conduction velocity distribution (SCVD) analysis was applied to the sural nerve of 21 normal volunteers and to 8 subjects with different diseases of the peripheral nervous system. The assessment of SCVD in normal subjects showed minimum values (90% of amplitude distribution) and maximum (10 % of amplitude distribution) conduction velocities of 19.5 + 5.3 m/s and 35.4 + II.2 m/s, respectively. For diagnostic purposes a sural nerve biopsy was also performed on the patients with neuropathy. Qualitative and quantitative correlations between neurophysiological and morphomebic data were then obtained. A preliminary statistical analysis showed a correlation coefficient between 0.57 and 0.97. Therefore SCVD seems a non-invasive technique to obtain more accurate details than ENG conventional on the fiber composition of the peripheral nerve and to detect subclinical neuropathies and their evolution. 85.
Utility and limits of interictal EEG - A. Primavera, S. Bisio, L. Cocito cal Sciences, University of Genova)
in the diagnosis of syncope. (Department of Nenrologi-
The assessment of patients with transient loss of consciousness usually includes EEG, even if history indicates a diagnosis of syncope. We carried out a retrospective study of 92 patients (48 men, 44 women; mean age 5 1.1 years _t 20.9SD), who underwent interictal EEG because one or more episodes of transient loss of consciousness, clinically diagnosed as syncopes. The type of syncope was vasovagal in 7%. postural hypotension in 13%, cardiac in 23%. situational in 12%; in 45% of patients no definite diagnosis could be established (unexplained syncope), although a vasovagal mechanism was conceivable in several cases. lnterictal EEG was normal in 83% and abnormal in 17% of patients. The abnormalities, however, were mild and unspecific, and never warranted any changes of the primary admission diagnosis. EEG abnormalities occurred very rarely in patients with unexplained syncope (9%) and more often in those with cardiac syncope (29%). possibly reflecting a concomitant cerebrovascular disease. These results indicate that interictal EEG is not helpful in patients with a history of syncope. 86.
Incidence 1994. - M. R. Cionia e Mentali. Universite
of carpal tunnel syndrome in the Siena area, 1991Mondelli, F. Gianninia, M. Giacchib, C. Paradisoa, (1st. di Scienze Nenrologiche. aCI. Malattie Nervose bDip. di Scienze Medico Legali e Socio Sanitarie, di Siena)
The incidence of new cases of carpal tunnel syndrome (CTS) in the 4-year period from 1991 to 1994 is reported for the residents of Health Department Area n. 30 of Tuscany, consisting of the Siena municipality and 16 other neighboring municipalities, The population of this area on 31 December 1993 was I19 508. In the 4-year period, 1460 CTS patients (82% female, 18% male, mean age 54.7 years, range 1397 years) were diagnosed on the basis of clinical symptoms and electrophysiological data. The annual incidence for the 4 years was 289, 320, 320, 317 in 100 000, respectively. The peak of highest frequency was between the ages of 50 and 59 years (30.7% of total). In women incidence increased gradually with age, reaching a peak between 50 and 59 years and declining. In males there was a progressive increase up to 50-59 years followed by a plateau. Rural and suburban areas had a higher incidence than urban areas. 87.
Human hand muscle H-reflexes evoked by means of a new methodological approach. - R. Mazzoccbio, C. Scarpini, A. Rossi (Laboratorio di Nenrofisiologia, Istitnto di Scienze Nenrologiche, Univ. Siena) We investigated
whether
H-reflexes
could
be obtained
from
small
Society Central motor conduction abnormalities in spinal ischemia associated with cocaine abuse. - P. Profice, V. Di Lazzaro, D. Restuccia, R. Nardone, A. Olviero, M. Pennisi, F. Della Corte, V. Mignani, P. Tonali (Universiti Cattolica, Roma)
Although over 300 cocaine related cerebrovascular diseases have been reported after the tirst description from Harlem Hospital Center in 1977, only a few cases of spinal ischemic disorders associated with cocaine abuse have been published. We describe two cases of acute myelopathy following intravenous injection of cocaine. The clinical features suggested the involvement of the territory of the cervical anterior spinal artery in the first patient and of the lumbar anterior spinal artery in the second patient. Central nervous system MRI revealed a cervical ischemic lesion in the former and was fully normal in the latter. A motor evoked potential study demonstrated an involvement of central motor pathways for both upper and lower limbs in patient one and for lower limbs only in patient two. It is concluded that electrophysiological studies, in addition to clinical assessment, can be helpful in diagnosing ischemic myelopathy due to cocaine abuse. 82.
Multimodal evoked potentials in migraine: preliminary data. - A. Ammendola, T. Marmoloa, R. Cantore, E. Giordanoa, G. Ugolini, V. Pizzaa, C. Colncci d’Amatoa, F. Bravaccio (Chair of Nenrophysiopatohology. aService of Diagnosis and Therapy of Cephaleas, Chair of Neurology II University of Naples)
Our previous study on visual evoked potentials in a group of migraine patients showed an increase in latency and a reduction of amplitude of PlOO wave. This is a report about the research on the behavior of somatosensory evoked potentials (SEPs) and the brainstem auditory potentials (BAEPs). In an intercritical phase, 20 migraine patients and a control group of 20 patients of the same age have been examined. The diagnosis has been made according to the ‘International Headache Society’ criteria. The SEPs by stimulation of median nerve and the brainstem auditory potentials have been studied. In comparison with the control group, the migraine patients SEPs show a decrease in latency and an increase in the amplitude of the N20 wave, while the BAEPs reveal an increase in the latency of the V wave and a decrease in the amplitude expressed by the ratio V wave/l wave. The resulting data, which are very difficult to interpret, could indicate the presence of central nervous system disorders in migraine patients, and, within these disorders, the involvement of various sensory systems. 83.
Longitudinal nenrophysiological study in asymptomatic hiv seropositive subjects. - P. Gambaro, M. Mauri, P. Bertora, P. Meravigliaa, A. Mangoni (Departments of Neurology. a2nd Infections Diseases, ‘L.Sacco’ Hospital, Milan, Italy)
The aim of this study was to evaluate early nervous system changes in neurologically asymptomatic HIV positive patients by multimodal evoked potentials (VEPs, BAEPs, P300, median and tibia1 nerves SSEPs). We selected 30 subjects (19 men, 1 I women, mean age 31.5 years) at CDC II, III, IVC2 and IVE stages without neurological symptoms. We present the results of baseline visits and follow-up: the data of 25 subjects at first control, 12 and 8 at the second and third are at present available. Data were analyzed by Student’s t test. VEPs, BAEPs and P300 results were normal. Median nerve SSEPs showed a prolonged N9-N13 difference (P < 0.05) at 6 and 12 months follow-up and a reduction in N20 wave amplitude (P < 0.005) at 12 and 18 months follow-up. Tibia1 nerve SSEPs showed a prolonged latency of P40 wave (P < 0.02) and an increase of CCT (P < 0.01) at 6 and 12 months follow-up. 84.
A study of snral nerve using conduction velocity distribution and morphometrlc analysis. - P. Valla, M. Osio, S. Iannaconea, M.R. Caccia, A. Qnattrinia, A. Salvaggiob, A. Mangoni
Proceedings (I Clinica Neurologica. aIV Igiene e Medicina Preventiva,
Clinica Nenrologica. Universite di Milano)
bIstitnto
di
In the present study the sensory conduction velocity distribution (SCVD) analysis was applied to the sural nerve of 21 normal volunteers and to 8 subjects with different diseases of the peripheral nervous system. The assessment of SCVD in normal subjects showed minimum values (90% of amplitude distribution) and maximum (10 % of amplitude distribution) conduction velocities of 19.5 + 5.3 m/s and 35.4 + II.2 m/s, respectively. For diagnostic purposes a sural nerve biopsy was also performed on the patients with neuropathy. Qualitative and quantitative correlations between neurophysiological and morphomebic data were then obtained. A preliminary statistical analysis showed a correlation coefficient between 0.57 and 0.97. Therefore SCVD seems a non-invasive technique to obtain more accurate details than ENG conventional on the fiber composition of the peripheral nerve and to detect subclinical neuropathies and their evolution. 85.
Utility and limits of interictal EEG - A. Primavera, S. Bisio, L. Cocito cal Sciences, University of Genova)
in the diagnosis of syncope. (Department of Nenrologi-
The assessment of patients with transient loss of consciousness usually includes EEG, even if history indicates a diagnosis of syncope. We carried out a retrospective study of 92 patients (48 men, 44 women; mean age 5 1.1 years _t 20.9SD), who underwent interictal EEG because one or more episodes of transient loss of consciousness, clinically diagnosed as syncopes. The type of syncope was vasovagal in 7%. postural hypotension in 13%, cardiac in 23%. situational in 12%; in 45% of patients no definite diagnosis could be established (unexplained syncope), although a vasovagal mechanism was conceivable in several cases. lnterictal EEG was normal in 83% and abnormal in 17% of patients. The abnormalities, however, were mild and unspecific, and never warranted any changes of the primary admission diagnosis. EEG abnormalities occurred very rarely in patients with unexplained syncope (9%) and more often in those with cardiac syncope (29%). possibly reflecting a concomitant cerebrovascular disease. These results indicate that interictal EEG is not helpful in patients with a history of syncope. 86.
Incidence 1994. - M. R. Cionia e Mentali. Universite
of carpal tunnel syndrome in the Siena area, 1991Mondelli, F. Gianninia, M. Giacchib, C. Paradisoa, (1st. di Scienze Nenrologiche. aCI. Malattie Nervose bDip. di Scienze Medico Legali e Socio Sanitarie, di Siena)
The incidence of new cases of carpal tunnel syndrome (CTS) in the 4-year period from 1991 to 1994 is reported for the residents of Health Department Area n. 30 of Tuscany, consisting of the Siena municipality and 16 other neighboring municipalities, The population of this area on 31 December 1993 was I19 508. In the 4-year period, 1460 CTS patients (82% female, 18% male, mean age 54.7 years, range 1397 years) were diagnosed on the basis of clinical symptoms and electrophysiological data. The annual incidence for the 4 years was 289, 320, 320, 317 in 100 000, respectively. The peak of highest frequency was between the ages of 50 and 59 years (30.7% of total). In women incidence increased gradually with age, reaching a peak between 50 and 59 years and declining. In males there was a progressive increase up to 50-59 years followed by a plateau. Rural and suburban areas had a higher incidence than urban areas. 87.
Human hand muscle H-reflexes evoked by means of a new methodological approach. - R. Mazzoccbio, C. Scarpini, A. Rossi (Laboratorio di Nenrofisiologia, Istitnto di Scienze Nenrologiche, Univ. Siena) We investigated
whether
H-reflexes
could
be obtained
from
small