- Email: [email protected]
Compression neuropathy in Parkinson's disease
Sll0 period, the more patients we found with advanced nerve damage. Of these patients, the affected side did not always correspond with the side of the vascular shunt. 12 patients (22 hands) were treated by surgical decompression and reinvestigated from 6 to 12 months after the operation. All of them improved clinically and electrophysiologically. These studies were compared with findings in 57 other patients, not uremic, with typical carpal tunnel syndrome.
sensory fibers close to motor fibers may become relatively ischemic. It was observed intraoperatively that pO 2 decreased at the entrapped nerve just after the stress to the innervated muscles, in spite of blood flow increase. It is suggested that the pathophysiological state of entrapment neuropathy might be further aggravated by relative ischemia.
PI0.06 ANOMALOUS MEDIAN AND ULNAR SENSORY INNERVATION IN T H E PALM. P10.04 C O M P R E S S I O N NEUROPATHY IN PARKINSON'S DISEASE.
J. lto, S. Yamao, S. Nakamura, T. Murachi and M. Kameyama (Kyoto, Japan)
Jagoda Potii" and Nikola Volf (Beograd, Yugoslavia) Patients with Parkinson's disease very often have hand deformity with hypotrophic muscles. EMG examination of peripheral nerves and muscles of the hands was performed in these patients. Our examination included 20 patients, age 40 to 68 years. The disease duration was 1 to 4 years. Hand deformity was identified in 65% of patients and that comprised two types: a) the thumb adducted and opposed, flexion of metaphalangeal joints with extension in interphalangeal joints, ulnar deviation in wrist and fingers, b) the thumb adducted and opposed, flexion of metaphalangeal and interphalangeal joints. Group a was more numerous (53%) than group b (17%) of patients. EMG findings indicated compression of n.medianus, n.ulnaris and n.radialis. N.medianus was compressed mostly (in 33% of patients), then n.medianus and n.radialis together (28%), and n.medianus and n.ulnaris together (18%). Both peripheral and central factors should be considered in the development of hand deformities in advanced Parkinson's disease.
Martin-Gruber anastomosis and Riche-Cannieu anastomosis are often found in normal subjects and such anastomoses sometimes cause misinterpretations of electro-diagnostic tests. Anomalous sensory innervation in the palm has not been studied previously. We studied 14 normal subjects and three siblings with congenital sensory impairment in the median nerve supply of the palm. Sensory nerve action potentials (SNAPs) were recorded with needle electrodes inserted in proximity to the median and ulnar nerves at the wrist as well as at the elbow. Short latency somatosensory evoked potentials (SEPs) were also recorded. Each finger was stimulated with ring electrodes. In three patients, the amplitude of the SNAPs following the little finger stimulation was larger in the median nerve than in the ulnar nerve. In two of them, no SNAPs were detected in the median nerve following stimulation of the thumb and the index finger, but the SEPs were preserved. Thus, their sensory impairment was found to be related to the anomalous sensory innervation. In four of the 14 subjects, the SNAPs following the little finger stimulation were also recorded in the median nerve, but the amplitude was smaller.
PI0.05 P A T H O P H Y S I O L O G I C A L STUDIES ON ENTRAPMENT NEUROPATHY.
M. Masuda, Y. Toyoshima, H. Matsuda and A. Shimazu
PI0.07 M O T O R AND SENSORY C O N D U C T I O N ALONG T H E P O S T E R I O R I N T E R O S S E O U S BRANCH OF THE RADIAL NERVE.
(Osaka. Japan)
M. LoMonaco, P.G. DiPasqua, M. Sabatelli and P. Tonali It was attempted to investigate the pathophysiology of entrapment neuropathy by measuring the orthodromic SNAPs before and after isometric contraction (stress) of the intrinsic muscles innervated by entrapped nerves (25 cases). These SNAPs were also observed during the ischemic state caused by applying a tourniquet to the upper arm in six healthy volunteers. Results: 1) The stress to the muscles innervated by entrapped nerves resulted in latency prolongation and amplitude decrease in the SNAPs. 2) In the healthy volunteers during ischemia, the stress to innervated muscles decreased the amplitude of the SNAPs more than stress to the muscles uninnervated by the measured nerve. 3) It was considered that motor nerve impulses during active muscle contraction gave rise to oxygen consumption at the entrapped site, and then,
(Rome, Italy) The diagnosis of entrapment neuropathy is based on the evidence of slowing of nerve conduction velocity across the affected nerve segment. [n the posterior interosseous branch of the radial nerve decreased motor nerve conduction velocity has been shown at the level of supinatoris brevis muscle in entrapment lesions (posterior interosseous entrapment, resistant tennis elbow). As the diagnostic yield of motor nerve conduction velocity study is increased by sensory nerve conduction velocity (SCV), we decided to measure the SCV along the deep sensory fibers of the posterior interosseous nerve.
sensory fibers close to motor fibers may become relatively ischemic. It was observed intraoperatively that pO 2 decreased at the entrapped nerve just after the stress to the innervated muscles, in spite of blood flow increase. It is suggested that the pathophysiological state of entrapment neuropathy might be further aggravated by relative ischemia.
PI0.06 ANOMALOUS MEDIAN AND ULNAR SENSORY INNERVATION IN T H E PALM. P10.04 C O M P R E S S I O N NEUROPATHY IN PARKINSON'S DISEASE.
J. lto, S. Yamao, S. Nakamura, T. Murachi and M. Kameyama (Kyoto, Japan)
Jagoda Potii" and Nikola Volf (Beograd, Yugoslavia) Patients with Parkinson's disease very often have hand deformity with hypotrophic muscles. EMG examination of peripheral nerves and muscles of the hands was performed in these patients. Our examination included 20 patients, age 40 to 68 years. The disease duration was 1 to 4 years. Hand deformity was identified in 65% of patients and that comprised two types: a) the thumb adducted and opposed, flexion of metaphalangeal joints with extension in interphalangeal joints, ulnar deviation in wrist and fingers, b) the thumb adducted and opposed, flexion of metaphalangeal and interphalangeal joints. Group a was more numerous (53%) than group b (17%) of patients. EMG findings indicated compression of n.medianus, n.ulnaris and n.radialis. N.medianus was compressed mostly (in 33% of patients), then n.medianus and n.radialis together (28%), and n.medianus and n.ulnaris together (18%). Both peripheral and central factors should be considered in the development of hand deformities in advanced Parkinson's disease.
Martin-Gruber anastomosis and Riche-Cannieu anastomosis are often found in normal subjects and such anastomoses sometimes cause misinterpretations of electro-diagnostic tests. Anomalous sensory innervation in the palm has not been studied previously. We studied 14 normal subjects and three siblings with congenital sensory impairment in the median nerve supply of the palm. Sensory nerve action potentials (SNAPs) were recorded with needle electrodes inserted in proximity to the median and ulnar nerves at the wrist as well as at the elbow. Short latency somatosensory evoked potentials (SEPs) were also recorded. Each finger was stimulated with ring electrodes. In three patients, the amplitude of the SNAPs following the little finger stimulation was larger in the median nerve than in the ulnar nerve. In two of them, no SNAPs were detected in the median nerve following stimulation of the thumb and the index finger, but the SEPs were preserved. Thus, their sensory impairment was found to be related to the anomalous sensory innervation. In four of the 14 subjects, the SNAPs following the little finger stimulation were also recorded in the median nerve, but the amplitude was smaller.
PI0.05 P A T H O P H Y S I O L O G I C A L STUDIES ON ENTRAPMENT NEUROPATHY.
M. Masuda, Y. Toyoshima, H. Matsuda and A. Shimazu
PI0.07 M O T O R AND SENSORY C O N D U C T I O N ALONG T H E P O S T E R I O R I N T E R O S S E O U S BRANCH OF THE RADIAL NERVE.
(Osaka. Japan)
M. LoMonaco, P.G. DiPasqua, M. Sabatelli and P. Tonali It was attempted to investigate the pathophysiology of entrapment neuropathy by measuring the orthodromic SNAPs before and after isometric contraction (stress) of the intrinsic muscles innervated by entrapped nerves (25 cases). These SNAPs were also observed during the ischemic state caused by applying a tourniquet to the upper arm in six healthy volunteers. Results: 1) The stress to the muscles innervated by entrapped nerves resulted in latency prolongation and amplitude decrease in the SNAPs. 2) In the healthy volunteers during ischemia, the stress to innervated muscles decreased the amplitude of the SNAPs more than stress to the muscles uninnervated by the measured nerve. 3) It was considered that motor nerve impulses during active muscle contraction gave rise to oxygen consumption at the entrapped site, and then,
(Rome, Italy) The diagnosis of entrapment neuropathy is based on the evidence of slowing of nerve conduction velocity across the affected nerve segment. [n the posterior interosseous branch of the radial nerve decreased motor nerve conduction velocity has been shown at the level of supinatoris brevis muscle in entrapment lesions (posterior interosseous entrapment, resistant tennis elbow). As the diagnostic yield of motor nerve conduction velocity study is increased by sensory nerve conduction velocity (SCV), we decided to measure the SCV along the deep sensory fibers of the posterior interosseous nerve.