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P10.7 Importance of different electrophysiological findings in early stages of diabetes melitus patients
Posters / Clinical Neurophysiology 117 (2006) S121–S336
required to evaluate the type of nerve fiber involvement and the site of damage. doi:10.1016/j.clinph.2006.06.318
P10.7 Importance of different electrophysiological findings in early stages of diabetes melitus patients M. Homam 22 Bahman Azad University, Neurology, Iran Background: Diabetic neuropathy is not only the most common cause of neuropathy around the world but also it is the most important cause of morbidity and mortality among these patients. Aims: To clarifying value of different electrophysiological findings for detecting neuropathy in early stages of diabetes mellitus. Patients and method: Thirty patients with early stages of diabetes (duration <6 months, adult onset, 2 fasten blood sugar > 126 mg per deciliter) were analyzied with complete neurophysiological tests (motoric and sensory branches of four limbs plus EMG) with Toeenies model during year 2004 in 22 Bahman Mashhad Azad Medical University. Results: Sensory median distal latency was abnormal in 78% of patients whereas NCV of motoric branches of proneal and tibialis nerve was abnormal in 57% of them. Abnormality of sural nerve and EMG findings (positive sharp waves and fibrillation) was detectable in 10%. Radial sensoy nerve was intact in all of the patients. Conclusion: We belive that routine electrophysiological tests is Indicated in all newly diagnosed diabetic patients. The most sensitive test is distal latency of sensory median nerve. EMG had the least value. doi:10.1016/j.clinph.2006.06.319
Methods: Case report and online search of relevant articles up to 2006 using PubMed. Results: A 50-year-old woman presented with typical symptoms of Wartenberg’s migrant sensory neuritis with asymmetrical persistent numbness of varying intensity in several nerve branches of the face, trunk and upper and lower limbs. A detailed neurophysiological assessment showed a significant reduction of sensory amplitudes with preserved sensory velocities in affected nerves with no evidence of motor system involvement. There was a striking association between the estimated amount of axon loss and the subjective numbness. A literature review identified ten case series with a total number of 32 patients since Wartenberg’s initial publication. Nineteen patients from five case series were excluded because of incomplete or inconsistent supportive data. Of the remaining 13 cases five had entirely normal nerve conduction studies and eight had reduced or absent sensory amplitudes only. Conclusions: A new case with the typical clinical features of Wartenberg’s migrant sensory neuritis and the associated neurophysiological findings of a multifocal purely sensory axonal neuropathy has been described. The neurophysiological abnormalities are consistent with previously published data from a small number of patients where sensory axonal loss corresponding to areas of numbness has been documented. doi:10.1016/j.clinph.2006.06.320
P11.1 Neurophysiological intraoperative monitoring of the thoracic pedicle screw placement R. Sola´ 1, I. Regidor 1, G. de Blas 1, N. Lebrato 1, L. Cabanes 1, A. Pedrera 1, J. Burgos 2 1 2
P10.8 Wartenberg’s migrant sensory neuritis: Report of 1 case and literature review of the associated neurophysiological findings S. Raasch 1, S. Hadjikoutis 2 1 2
Morriston Hospital, Clinical Neurophysiology, UK Morriston Hospital, Neurology, UK
Background: Wartenberg’s migrant sensory neuritis is an acute painful relapsing and remitting purely sensory mononeuritis multiplex of adult life. Nerve biopsies have shown degeneration of axonal sensory fibres, generally with no evidence of significant inflammation, and the aetiology remains unclear. Treatment is symptomatic as immunosuppressive therapies are not effective. The overall prognosis is benign, although numbness can persist indefinitely. Objectives: To present a new case of Wartenberg’s migrant sensory neuritis and review the neurophysiological findings in previously published cases.
S179
Ramon y Cajal, Clinical Neurophysiology, Spain Ramon y Cajal, Orthopaedics, Spain
Background: The use of triggered electromyographic testing has proven helpful in identifying medially placed lumbar pedicle screws but results in assessment of thoracic screws have been inconsistent. Objective: To report our experience in the neurophysiological control of the accurately placing of the thoracic pedicle screws in an experimental study made in a porcine model and in 15 cases of patients undergoing scoliosis surgery. Methods: Experimental study: We have evaluated in six pigs the threshold stimulus intensity of the thoracic pedicles recording in the corresponding and the contralateral myotoma in the following conditions: stimulation of the track and the screw in intact pedicles, medial cortical breakage and external cortical breakage. In patients with scoliosis the intensity threshold has been determined stimulating the track and the screw once placed, identifying screw placement with computed tomographic (CT) scans.
required to evaluate the type of nerve fiber involvement and the site of damage. doi:10.1016/j.clinph.2006.06.318
P10.7 Importance of different electrophysiological findings in early stages of diabetes melitus patients M. Homam 22 Bahman Azad University, Neurology, Iran Background: Diabetic neuropathy is not only the most common cause of neuropathy around the world but also it is the most important cause of morbidity and mortality among these patients. Aims: To clarifying value of different electrophysiological findings for detecting neuropathy in early stages of diabetes mellitus. Patients and method: Thirty patients with early stages of diabetes (duration <6 months, adult onset, 2 fasten blood sugar > 126 mg per deciliter) were analyzied with complete neurophysiological tests (motoric and sensory branches of four limbs plus EMG) with Toeenies model during year 2004 in 22 Bahman Mashhad Azad Medical University. Results: Sensory median distal latency was abnormal in 78% of patients whereas NCV of motoric branches of proneal and tibialis nerve was abnormal in 57% of them. Abnormality of sural nerve and EMG findings (positive sharp waves and fibrillation) was detectable in 10%. Radial sensoy nerve was intact in all of the patients. Conclusion: We belive that routine electrophysiological tests is Indicated in all newly diagnosed diabetic patients. The most sensitive test is distal latency of sensory median nerve. EMG had the least value. doi:10.1016/j.clinph.2006.06.319
Methods: Case report and online search of relevant articles up to 2006 using PubMed. Results: A 50-year-old woman presented with typical symptoms of Wartenberg’s migrant sensory neuritis with asymmetrical persistent numbness of varying intensity in several nerve branches of the face, trunk and upper and lower limbs. A detailed neurophysiological assessment showed a significant reduction of sensory amplitudes with preserved sensory velocities in affected nerves with no evidence of motor system involvement. There was a striking association between the estimated amount of axon loss and the subjective numbness. A literature review identified ten case series with a total number of 32 patients since Wartenberg’s initial publication. Nineteen patients from five case series were excluded because of incomplete or inconsistent supportive data. Of the remaining 13 cases five had entirely normal nerve conduction studies and eight had reduced or absent sensory amplitudes only. Conclusions: A new case with the typical clinical features of Wartenberg’s migrant sensory neuritis and the associated neurophysiological findings of a multifocal purely sensory axonal neuropathy has been described. The neurophysiological abnormalities are consistent with previously published data from a small number of patients where sensory axonal loss corresponding to areas of numbness has been documented. doi:10.1016/j.clinph.2006.06.320
P11.1 Neurophysiological intraoperative monitoring of the thoracic pedicle screw placement R. Sola´ 1, I. Regidor 1, G. de Blas 1, N. Lebrato 1, L. Cabanes 1, A. Pedrera 1, J. Burgos 2 1 2
P10.8 Wartenberg’s migrant sensory neuritis: Report of 1 case and literature review of the associated neurophysiological findings S. Raasch 1, S. Hadjikoutis 2 1 2
Morriston Hospital, Clinical Neurophysiology, UK Morriston Hospital, Neurology, UK
Background: Wartenberg’s migrant sensory neuritis is an acute painful relapsing and remitting purely sensory mononeuritis multiplex of adult life. Nerve biopsies have shown degeneration of axonal sensory fibres, generally with no evidence of significant inflammation, and the aetiology remains unclear. Treatment is symptomatic as immunosuppressive therapies are not effective. The overall prognosis is benign, although numbness can persist indefinitely. Objectives: To present a new case of Wartenberg’s migrant sensory neuritis and review the neurophysiological findings in previously published cases.
S179
Ramon y Cajal, Clinical Neurophysiology, Spain Ramon y Cajal, Orthopaedics, Spain
Background: The use of triggered electromyographic testing has proven helpful in identifying medially placed lumbar pedicle screws but results in assessment of thoracic screws have been inconsistent. Objective: To report our experience in the neurophysiological control of the accurately placing of the thoracic pedicle screws in an experimental study made in a porcine model and in 15 cases of patients undergoing scoliosis surgery. Methods: Experimental study: We have evaluated in six pigs the threshold stimulus intensity of the thoracic pedicles recording in the corresponding and the contralateral myotoma in the following conditions: stimulation of the track and the screw in intact pedicles, medial cortical breakage and external cortical breakage. In patients with scoliosis the intensity threshold has been determined stimulating the track and the screw once placed, identifying screw placement with computed tomographic (CT) scans.