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Journal of Clinical Neuromuscular... Jun 2022To evaluate the utility of repetitive nerve stimulation test (RNS) for differentiating multifocal motor neuropathy (MMN) and progressive muscular atrophy (PMA).
OBJECTIVES
To evaluate the utility of repetitive nerve stimulation test (RNS) for differentiating multifocal motor neuropathy (MMN) and progressive muscular atrophy (PMA).
METHODS
We retrospectively enrolled 20 patients with MMN or PMA. We extracted the results of the initial 3-Hz RNS in the ulnar and accessory nerves and compared the percentage and frequency of abnormal decremental responses between both groups.
RESULTS
RNS was performed in 8 ulnar and 9 accessory nerves in patients with MMN, and in 8 ulnar and 10 accessory nerves in patients with PMA. Patients with MMN had a significantly lower decrement percentage (0.6 ± 4.0% in MMN vs. 10.3 ± 6.5% in PMA, P < 0.01) and frequency of abnormal decremental response (0 of 9 in MMN vs. 6 of 10 in PMA, P = 0.01) than patients with PMA in the accessory nerve.
CONCLUSIONS
The RNS has clinical utility for differentiating MMN from PMA.
Topics: Electric Stimulation; Humans; Muscular Atrophy, Spinal; Neural Conduction; Polyneuropathies; Retrospective Studies
PubMed: 35608640
DOI: 10.1097/CND.0000000000000401 -
Neurology Research International 2010Classically, the accessory nerve is described as having a cranial and a spinal root. Textbooks are inconsistent with regard to the modality of the spinal root of the...
Classically, the accessory nerve is described as having a cranial and a spinal root. Textbooks are inconsistent with regard to the modality of the spinal root of the accessory nerve. Some authors report the spinal root as general somatic efferent (GSE), while others list a special visceral efferent (SVE) modality. We investigated the comparative, anatomical, embryological, and molecular literature to determine which modality of the accessory nerve was accurate and why a discrepancy exists. We traced the origin of the incongruity to the writings of early comparative anatomists who believed the accessory nerve was either branchial or somatic depending on the origin of its target musculature. Both theories were supported entirely by empirical observations of anatomical and embryological dissections. We find ample evidence including very recent molecular experiments to show the cranial and spinal root are separate entities. Furthermore, we determined the modality of the spinal root is neither GSE or SVE, but a unique peripheral nerve with a distinct modality. We propose a new classification of the accessory nerve as a transitional nerve, which demonstrates characteristics of both spinal and cranial nerves.
PubMed: 21318044
DOI: 10.1155/2010/476018 -
Frontiers in Surgery 2022This study aims to evaluate the impact of the inferior petrosal veins (IPVs) on operational exploration and to analyze related anatomic features.
OBJECTIVE
This study aims to evaluate the impact of the inferior petrosal veins (IPVs) on operational exploration and to analyze related anatomic features.
METHODS
A total of 317 patients were retrospectively studied. Surgical outcomes and postoperative complications were analyzed, and patients were divided into two groups according to whether the IPV was sacrificed or preserved. The diameter of the IPV was also recorded during operation. Furthermore, the position where the IPV drained into the jugular bulb was recorded in each patient, and the influence of different injection points on the operation was analyzed.
RESULTS
IPVs were conclusively identified in 242/317 (76.3%) of patients, with 110/242 (45.5%) of patients categorized as "IPV sacrifice" versus 132/242 (54.5%) categorized as "IPV preservation." IPV diameter was observed to be <0.5 mm in 58 cases (23.9%), 0.5 mm-1.0 mm (≥0.5 mm and ≤1.0 mm) in 145 cases (59.9%), and >1 mm in 39 cases (16.2%). The position of IPV drainage into the jugular bulb was at the level of the accessory nerve in 163 cases (67.3%), the level of the vagus nerve in 42 cases (17.4%), and the level of the glossopharyngeal nerve or above in 37 cases (15.3%). The diameters of IPV in the sacrifice group were mainly less than 1 mm (94.5% vs. 75%, < 0.01), and the cases with draining points near the glossopharyngeal nerve were more than that in the preservation group (27.3% vs. 5.3%, < 0.01).
CONCLUSION
IPV is an obstructive structure in MVD for HFS, with considerable variations in diameters and draining points. IPV near the glossopharyngeal nerve significantly impacts surgical exposure and is often sacrificed for a better view of the operation field. Meanwhile, it is feasible to maintain IPVs with a diameter >1 mm.
PubMed: 35756473
DOI: 10.3389/fsurg.2022.921589 -
BMC Medical Imaging Dec 2023The purpose of this study was to investigate the clinical utility of three-dimension (3D) high-resolution inversion recovery (IR)-prepared fast spoiled gradient-recalled...
PURPOSE
The purpose of this study was to investigate the clinical utility of three-dimension (3D) high-resolution inversion recovery (IR)-prepared fast spoiled gradient-recalled (SPGR) magnetic resonance imaging (MRI) in the diagnosis of cranial nerve meningeal carcinomatosis (MC).
METHODS
A total of 114 patients with MC from January 2015 to March 2020 were enrolled and their MRIs were analyzed retrospectively. All patients underwent MRIs before being administered a contrast agent. Both a 2D conventional MRI sequence and a 3D IR-prepared fast SPGR high-resolution T1-weighted (BRAVO) scan sequence were measured after contrast agent administration. The characteristics of MC and the involved cranial nerves were then examined.
RESULTS
Among the 114 MC patients, 81 (71.05%) had cranial nerve enhancement on contrast-enhanced 3D-BRAVO imaging, while only 41 (35.96%) had image enhancement on conventional MRI. The contrast-enhanced 3D-BRAVO displayed stronger image contrast enhancement of the cranial nerves than the conventional MRI (P < 0.001). Furthermore, detection rates for the facial and auditory nerves, trigeminal nerve, oculomotor nerve, sublingual nerve, optic nerve, glossopharyngeal/vagal/accessory nerve, and abductor nerve on contrast-enhanced 3D-BRAVO imaging were 58.77%, 47.37%, 9.65%, 8.77%, 5.26%, 3.51%, and 0.88%, respectively. We found a statistically significant difference between the affected facial and auditory nerves, as well as the trigeminal nerve, oculomotor nerve, sublingual nerve, and optic nerve.
CONCLUSION
In MC, contrast-enhanced 3D-BRAVO imaging displayed the cranial nerves more effectively than 2D conventional enhanced MRI. The facial, auditory, and trigeminal nerves are the primary nerves involved in MC, and improved scanning of these nerves would aid in the early detection and treatment of MC.
Topics: Humans; Contrast Media; Retrospective Studies; Meningeal Carcinomatosis; Cranial Nerves; Magnetic Resonance Imaging; Imaging, Three-Dimensional
PubMed: 38082242
DOI: 10.1186/s12880-023-01166-4 -
Acta Otorhinolaryngologica Italica :... Feb 2018Nerve and vein preserving modification of the radical neck dissection is commonly used in the management of oral squamous cell cancers. There is limited literature...
Nerve and vein preserving neck dissections for oral cancers: a prospective evaluation of spinal accessory nerve function and internal jugular vein patency following treatment.
Nerve and vein preserving modification of the radical neck dissection is commonly used in the management of oral squamous cell cancers. There is limited literature addressing nerve function and vein patency following treatment. We prospectively analysed 65 patients with nerve conduction study using surface electromyography at baseline, 1 month and 6 months post-surgery and colour Doppler of the internal jugular vein at baseline and 1 month post-surgery. We also studied functional outcomes of nerve sparing with arm abduction test and Neck Dissection Quality of Life questionnaire. There was a statistically significant increase in mean latency of motor action potential and decrease in the mean amplitude of the motor action potential following surgery, suggesting nerve dysfunction. Following surgery, there was a significant decrease in the diameter of the vein as well as an increase in the velocity of blood flow; there was partial thrombus in 5% of individuals. In conclusion, even though nerve dysfunction compromised shoulder abduction, vein dysfunction rarely resulted in any significant clinical impact.
Topics: Accessory Nerve; Female; Humans; Jugular Veins; Male; Middle Aged; Mouth Neoplasms; Neck Dissection; Organ Sparing Treatments; Prospective Studies; Quality of Life; Vascular Patency
PubMed: 29087403
DOI: 10.14639/0392-100X-1481 -
Ear, Nose, & Throat Journal Sep 2021
Topics: Accessory Nerve; Accessory Nerve Diseases; Adult; Carcinoma, Papillary; Female; Horner Syndrome; Humans; Postoperative Complications; Thyroid Cancer, Papillary; Thyroid Neoplasms; Thyroidectomy
PubMed: 32075435
DOI: 10.1177/0145561320907714 -
Frontiers in Neurology 2018The vagus nerve has been suggested to represent one major route of disease progression in Parkinson's disease (PD). Here, we examined whether patients with idiopathic...
The vagus nerve has been suggested to represent one major route of disease progression in Parkinson's disease (PD). Here, we examined whether patients with idiopathic PD exhibit an atrophy of the vagus nerve in comparison to age-matched controls. In this cross-sectional study, performed between July 2017 and January 2018, we measured the caliber (cross-sectional area) of the mid-cervical vagus, accessory and phrenic nerves in 20 patients with PD (disease duration: 10.1 ± 7.4 years) and 61 (including 20 age-matched) controls using high-resolution ultrasonography. Ultrasonography and assessments of autonomic function were performed by blinded raters. Mean vagus nerve calibers were lower in patients with PD compared to age-matched controls (right: 0.64 ± 0.17 vs. 1.04 ± 0.20; left: 0.69 ± 0.18 vs. 0.87 ± 0.15 mm; < 0.001) while accessory and phrenic nerve calibers did not differ. In controls, age correlated negatively with calibers of the accessory and the phrenic nerve (each ≤ 0.001), and trended to correlate with vagus nerve caliber ( = 0.023). In patients with PD and age-matched controls combined, the summed caliber of the right and left vagus nerves correlated with the burden of autonomic symptoms on the PD Non-Motor Symptoms Questionnaire ( = -0.46; = 0.003). Moreover, the caliber of the right but not of the left vagus nerve correlated with the parasympathetic domain of heart rate variability ( = 0.58; = 0.001). PD is associated with a bilateral atrophy of the vagus nerve but not of the spinal accessory or the phrenic nerves. Our findings suggest that viscero-afferent and viscero-efferent vagal fibers are predominantly affected in PD.
PubMed: 30319534
DOI: 10.3389/fneur.2018.00805 -
Journal of Neurosurgery. Case Lessons Jan 2022Injury to the spinal accessory nerve (Acc) results in loss of motor function of the trapezius muscle and leads to severe shoulder problems. A vast number of surgical...
BACKGROUND
Injury to the spinal accessory nerve (Acc) results in loss of motor function of the trapezius muscle and leads to severe shoulder problems. A vast number of surgical strategies have been proposed to reinnervate (suture, grafting, and nerve transfers) or compensate (tendon and muscle transfers) the lost function of the trapezius muscle.
OBSERVATIONS
The authors report a successful case of Acc reconstruction 5 months after the injury with the anterior C3 levator scapulae motor nerve branch transfer in omotrapezoid triangle of the neck.
LESSONS
The advantages of the proposed technique over preexisting nerve transfers were discussed. We believe that this technique can be considered as an alternative to already existing techniques for proximal injuries to Acc.
PubMed: 36130564
DOI: 10.3171/CASE21609 -
Journal of Neurology, Neurosurgery, and... Nov 1977After apparently uncomplicated excision of benign lesions in the posterior cervical triangle, two patients had shoulder pain. In one, neck pain and trapezius weakness...
After apparently uncomplicated excision of benign lesions in the posterior cervical triangle, two patients had shoulder pain. In one, neck pain and trapezius weakness were not prominent until one month after surgery. Inability to elevate the arm above the horizontal without externally rotating it, and prominent scapular displacement on arm abduction, but not on forward pushing movements, highlighted the trapezius dysfunction and differentiated it from serratus anterior weakness. Spinal accessory nerve lesions should be considered when minor surgical procedures, lymphadenitis, minor trauma, or tumours involved the posterior triangle of the neck.
Topics: Accessory Nerve; Accessory Nerve Injuries; Adult; Diagnosis, Differential; Female; Head and Neck Neoplasms; Humans; Lymphadenitis; Male; Middle Aged; Neck; Paralysis; Peripheral Nervous System Diseases; Surgical Procedures, Operative; Syndrome
PubMed: 202681
DOI: 10.1136/jnnp.40.11.1113