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Revista de Neurologia Oct 2011Carpal tunnel syndrome (CTS) is the most common of all focal neuropathies. Its diagnosis is based on a neurophysiological study of the thick motor and sensory fibres in...
INTRODUCTION
Carpal tunnel syndrome (CTS) is the most common of all focal neuropathies. Its diagnosis is based on a neurophysiological study of the thick motor and sensory fibres in patients with a characteristic clinical picture, although sometimes, in mild cases, this study does not detect the abnormalities. The decision was made to evaluate the small-calibre sympathetic fibres by means of cutaneous-plantar reflex (CPR) in patients with different degrees of idiopathic CTS.
SUBJECTS AND METHODS
The study involved 54 cases -15 males and 39 females with CTS- and 15 healthy volunteer controls. The cases were divided into three groups: those with only positive clinical features; those with clinical features and alteration of sensory conduction; and those with clinical features, alteration of sensory and motor conduction, and axonal loss. The CPR was obtained by means of the usual technique (which we modified), involving stimulation of the median nerve in the wrist and recording the response in the contralateral hand. Two successive responses were processed with an interval of more than one minute between them. Special attention was paid to controlling the baseline and sweating. A descriptive statistical inference and correlation analysis was performed.
RESULTS
A decrease in amplitude of the response was observed in patients with CTS, with shorter latencies in women and a good correlation between the latencies of the first and the second response. No significant differences were observed in the other parameters that were studied.
CONCLUSION
Studying the CPR can provide complementary data in the evaluation of CTS.
Topics: Adult; Carpal Tunnel Syndrome; Female; Humans; Male; Median Nerve; Middle Aged; Neural Conduction; Reflex; Reflex, Abnormal; Young Adult
PubMed: 21960386
DOI: No ID Found -
American Journal of Veterinary Research Nov 2002To evoke and measure the nociceptive withdrawal reflex (NWR) by use of electromyographic recordings and to score the behavioral nociceptive responses to electrical...
OBJECTIVES
To evoke and measure the nociceptive withdrawal reflex (NWR) by use of electromyographic recordings and to score the behavioral nociceptive responses to electrical pulses in standing nonsedated horses.
ANIMALS
10 adult horses.
PROCEDURE
The lateral palmar digital nerve of the forelimb was transcutaneously stimulated, and surface electromyographic responses were recorded from the ulnaris lateralis, extensor carpi radialis, and common digital extensor muscles. Stimuli consisted of a 25-millisecond train of 5 constant-current pulses delivered by a computer-controlled stimulator. The 80- to 250-milliseconds poststimulation interval was analyzed to detect the NWR. The current intensity was increased in steps of 0.5 mA until the NWR threshold intensity (lt) was reached. The stimulus at It was repeated twice. Latency and amplitude of the NWR, together with the behavioral reaction of horses, were analyzed. The latter was scored according to a scale from 0 (no reaction) to 5 (vigorous reaction). Finally, 3 suprathreshold stimuli at 1.2 X It were analyzed.
RESULTS
The median It to elicit NWR was 2.5 mA. Median onset latency of the NWR was 96.0 milliseconds at It and 89.6 milliseconds for suprathreshold stimuli. The amplitude of the reflexes was higher for suprathreshold stimulations, and behavioral reactions were slightly stronger when stimulus intensity increased.
CONCLUSIONS AND CLINICAL RELEVANCE
Results of our study indicate that it is possible to record NWR in conscious standing horses, to define a reflex threshold, and to measure reflexes in response to increasing stimulus intensity.
Topics: Animals; Electromyography; Female; Horses; Male; Nociceptors; Pain; Pain Measurement; Pain Threshold; Reflex; Transcutaneous Electric Nerve Stimulation
PubMed: 12428666
DOI: 10.2460/ajvr.2002.63.1551 -
Iranian Journal of Child Neurology 2012Congenital insensitivity to pain and anhidrosis (CIPA) or hereditary sensory autonomic neuropathies type IV (HSAN type IV) is an extremely rare autosomal recessive...
Congenital insensitivity to pain and anhidrosis (CIPA) or hereditary sensory autonomic neuropathies type IV (HSAN type IV) is an extremely rare autosomal recessive disorder initially described by Swanson in 1963. We report a 2.5-year-old boy with clinical features of CIPA as the first case in Iran. The symptoms included recurrent episodes of hyperthermia and unexplained fever that began in early infancy, anhidrosis (inability to sweat), profound loss of pain sensitivity, neurodevelopmental delay, unconscious self-mutilation of fingers, lips and tongue, corneal lacerations, palmar hyperkeratosis, non-painful fracture and joint deformities in the right ankle. Tearing, deep tendon reflexes and motor and sensory nerve action potentials were normal. Prenatal screening is the sole accessible option to prevent the birth of an affected child as no cure is available. Early recognition of CIPA patients and its orthopedic complications, prevention of accidental injuries, regular visual and eye follow-up and specific dental management could be useful in the reduction of frequency and severity of complications.
PubMed: 24665272
DOI: No ID Found -
Arquivos de Neuro-psiquiatria Jun 2005A non-controlled, prognostic cohort study was performed with the aim of establishing markers of neurological development and defining a clinical and epidemiological...
UNLABELLED
A non-controlled, prognostic cohort study was performed with the aim of establishing markers of neurological development and defining a clinical and epidemiological profile of preterm newborns at 3, 6, 9, and 12 months of gestation-corrected age in terms of primitive reflexes evolution.
RESULTS
At 3 months old of corrected age, all primitive reflexes were present. At 6 months old, all children showed plantar grasp and 2.7% still showed Moro and palmar grasp. Plantar grasp was the unique primitive reflex found at 9 and 12 months of corrected age.
CONCLUSION
It was possible to evaluate the occurence, as well as the disappearing of primitive reflexes in preterm newborns. The results show delay in the disappearing of primitive reflexes even with the use of corrected age.
Topics: Child Development; Cohort Studies; Confidence Intervals; Humans; Infant; Infant, Newborn; Infant, Premature; Neurologic Examination; Reflex
PubMed: 16100977
DOI: 10.1590/s0004-282x2005000200017 -
Jornal Brasileiro de Pneumologia :... 2007To compare different levels of ablation in terms of the degree of patient satisfaction and extent of postoperative reflex sweating in sympathectomized patients.
OBJECTIVE
To compare different levels of ablation in terms of the degree of patient satisfaction and extent of postoperative reflex sweating in sympathectomized patients.
METHODS
A retrospective study involving 521 patients with primary hyperhidrosis, submitted to thoracic sympathectomy at the Monte Sinai Hospital and University Hospital of the Federal University of Juiz de Fora, from January of 2001 to December 2005. All patients were submitted to thermal ablation of the sympathetic stem and were divided into three groups: up to T2 (group I, n = 162); up to T3 (group II, n = 65); and up to T4 (group III, n = 294).
RESULTS
Optimal postoperative control of palmar/axillary hyperhidrosis was achieved in, respectively, 94/82% of the patients of group I, 89/89% of those in group II and 80/80% of those in group III. Postoperative reflex sweating was observed in 67% of the patients in groups I and II, compared with 61.29% of those in group III. Severe reflex sweating occurred in 32% of the group I patients, 9% of the group II patients and 4% of the group III patients.
CONCLUSION
Sympathectomy provided excellent patient satisfaction and a low incidence of complications. There was no significant difference between the levels of ablation in terms of reflex sweating, although the intensity of this complication decreased when lower levels of blockage, principally at the T4 level, were employed.
Topics: Adolescent; Adult; Aged; Axilla; Chi-Square Distribution; Child; Female; Follow-Up Studies; Hand; Humans; Hyperhidrosis; Male; Middle Aged; Patient Satisfaction; Reflex; Retrospective Studies; Sweating; Sympathectomy; Thoracic Nerves; Thoracic Surgery, Video-Assisted; Treatment Outcome
PubMed: 17906784
DOI: 10.1590/s1806-37132007000300004 -
Physiological Measurement Oct 2011Measurements of blood volume pulse (BVP) and skin conductance are commonly used as indications of psychological arousal in affective computing and human-machine... (Clinical Trial)
Clinical Trial Comparative Study
Measurements of blood volume pulse (BVP) and skin conductance are commonly used as indications of psychological arousal in affective computing and human-machine interfaces. To date, palmar surfaces remain the primary site for these measurements. Placement of sensors on palmar surfaces, however, is undesirable when recordings are fraught with motion and pressure artifacts. These artifacts are frequent when the human participant has involuntary movements as in hyperkinetic cerebral palsy. This motivates the use of alternative measurement sites. The present study examined the correlation between measurements of blood volume pulse and skin conductance obtained from three different sites on the body (fingers, toes and ear for BVP; fingers, toes and arch of the foot for skin conductance) in response to cognitive and affective stimuli. The results of this pilot study indicated significant inter-site correlation among signal features derived from different sites, with the exception of BVP amplitude, the number of electrodermal reactions and the slope of the electrodermal activity response. We attribute these differences in part to inter-site discrepancies in local skin conditions, such as skin temperature. Despite these differences, significant changes from baseline were present in the responses to the cognitive and affective stimuli at non-palmar sites, suggesting that these sites may provide viable signal measurements for use in affective computing and human-machine interface applications.
Topics: Blood Volume; Cognition; Female; Galvanic Skin Response; Humans; Male; Music; Organ Specificity; Physical Stimulation; Pulse; Regression Analysis; Signal Processing, Computer-Assisted; Time Factors; Young Adult
PubMed: 21849720
DOI: 10.1088/0967-3334/32/10/002 -
American Journal of Veterinary Research May 2007To determine the durations of the local anesthetic effect and plasma procaine concentrations associated with 5- and 10-mg doses of procaine hydrochloride (with or... (Randomized Controlled Trial)
Randomized Controlled Trial
OBJECTIVE
To determine the durations of the local anesthetic effect and plasma procaine concentrations associated with 5- and 10-mg doses of procaine hydrochloride (with or without 100 microg of epinephrine) administered SC over the lateral palmar digital nerves of horses.
ANIMALS
6 healthy adult horses.
PROCEDURES
The hoof withdrawal reflex latency (HWRL) period was determined by use of a focused heat lamp before and after administration of procaine with and without epinephrine. Blood samples were collected immediately before determination of each HWRL period to assess plasma concentrations of procaine via liquid chromatography-mass spectrometry-mass spectrometry (LC-MS-MS).
RESULTS
10 but not 5 mg of procaine alone and 5 and 10 mg of procaine administered with epinephrine significantly prolonged the HWRL period (mean durations of effect, 5, 120 and 180 minutes, respectively), compared with baseline values. Plasma procaine concentrations did not correlate well with local anesthetic activity; for example, although the HWRL was prolonged to the maximum permitted duration of 20 seconds at 60 to 180 minutes following administration of the 5-mg dose of procaine with epinephrine in certain horses, plasma procaine concentrations were less than the limit of quantitation of the LC-MS-MS assay.
CONCLUSIONS AND CLINICAL RELEVANCE
Small doses of procaine coadministered with epinephrine provided long-lasting local analgesia and resulted in plasma procaine concentrations that were not always detectable via LC-MS-MS. On the basis of these results, the use of regulatory limits or thresholds for procaine concentration in equine plasma samples obtained after racing should be seriously reconsidered.
Topics: Anesthesia, Local; Anesthetics, Local; Animals; Cross-Over Studies; Dose-Response Relationship, Drug; Female; Horses; Injections, Subcutaneous; Male; Procaine; Time Factors
PubMed: 17472448
DOI: 10.2460/ajvr.68.5.495 -
Journal of Neurophysiology Feb 2010The present work investigated presynaptic modulation of Ia afferents in the extensor carpi radialis (ECR) when young and old adults exerted a wrist extension force...
The present work investigated presynaptic modulation of Ia afferents in the extensor carpi radialis (ECR) when young and old adults exerted a wrist extension force either to support an inertial load (position control) or to achieve an equivalent constant torque against a rigid restraint (force control) at 5, 10, and 15% of the maximal force. H reflexes were evoked in the ECR by stimulating the radial nerve above the elbow. A conditioning stimulus was applied to the median nerve above the elbow to assess presynaptic inhibition of homonymous Ia afferents (D1 inhibition) or at the wrist (palmar branch) to assess the ongoing presynaptic inhibition of heteronymous Ia afferents that converge onto the ECR motor neuron pool (heteronymous Ia facilitation). The young adults had less D1 inhibition and greater heteronymous Ia facilitation during the position task (79 and 132.1%, respectively) compared with the force task (69.1 and 115.1%, respectively, P < 0.05). In contrast, the old adults exhibited no difference between the two tasks for either D1 inhibition ( approximately 72%) or heteronymous Ia facilitation ( approximately 114%). Contraction intensity did not influence the amount of D1 inhibition or heteronymous Ia facilitation for either group of subjects. The amount of antagonist coactivation was similar between tasks for young adults, whereas it was greater in the position task for old adults (P = 0.02). These data indicate that in contrast to young adults, old adults did not modulate presynaptic inhibition of Ia afferents when controlling the position of a compliant load but rather increased coactivation of the antagonist muscle.
Topics: Adult; Afferent Pathways; Aged; Aging; Feedback, Sensory; Female; H-Reflex; Humans; Male; Movement; Muscle Contraction; Muscle, Skeletal; Postural Balance; Posture; Presynaptic Terminals; Stress, Mechanical; Task Performance and Analysis; Wrist Joint
PubMed: 19939955
DOI: 10.1152/jn.00839.2009 -
Physiological Research 2013In this study, we tested the hypothesis that experimental stress induces a specific change of left-right electrodermal activity (EDA) coupling pattern, as indexed by...
In this study, we tested the hypothesis that experimental stress induces a specific change of left-right electrodermal activity (EDA) coupling pattern, as indexed by pointwise transinformation (PTI). Further, we hypothesized that this change is associated with scores on psychometric measures of the chronic stress-related psychopathology. Ninety-nine university students underwent bilateral measurement of EDA during rest and stress-inducing Stroop test and completed a battery of self-report measures of chronic stress-related psychopathology. A significant decrease in the mean PTI value was the prevalent response to the stress conditions. No association between chronic stress and PTI was found. Raw scores of psychometric measures of stress-related psychopathology had no effect on either the resting levels of PTI or the amount of stress-induced PTI change. In summary, acute stress alters the level of coupling pattern of cortico-autonomic influences on the left and right sympathetic pathways to the palmar sweat glands. Different results obtained using the PTI, EDA laterality coefficient, and skin conductance level also show that the PTI algorithm represents a new analytical approach to EDA asymmetry description.
Topics: Adult; Algorithms; Female; Galvanic Skin Response; Humans; Lie Detection; Male; Psychometrics; Reproducibility of Results; Sensitivity and Specificity; Skin; Stress, Psychological
PubMed: 24359433
DOI: 10.33549/physiolres.932589 -
The Journal of Physiology Oct 19941. The possibility was investigated that, in man, some of the descending command for tonic voluntary wrist extension is transmitted to extensor motoneurones over a... (Clinical Trial)
Clinical Trial
1. The possibility was investigated that, in man, some of the descending command for tonic voluntary wrist extension is transmitted to extensor motoneurones over a non-monosynaptic pathway. 2. Stimulation of the cutaneous superficial radial nerve at 3 times perceptual threshold depressed the electromyogram (EMG) of extensor carpi radialis (ECR) and the discharge of single ECR motor units, both with a mean central delay of 4.2 ms. Such stimuli depressed the response to transcranial magnetic stimulation of the motor cortex, but had little effect on the H reflex. 3. The possibility that the relative sparing of the H reflex was due to an alteration in transmission of the afferent volley for the H reflex was excluded. 4. The central latency of the cutaneous-induced depression of the discharge of single motor units in biceps brachii (C5-C6) was shorter by about 1 ms than that of the more caudal wrist and finger extensor motor units. This suggests that the locus for the cutaneous-induced effects was spinal but above the cervical enlargement. 5. The pattern of EMG depression (evoked by superficial radial but not palmar stimuli, in wrist extensors but not wrist flexors) is that previously described for the presumed propriospinal system of human subjects. 6. It is concluded that a significant component of the voluntary command for tonic wrist extension reaches the relevant motoneurone pool via a non-monosynaptic pathway. It is suggested that the interposed neurones could be C3-C4 propriospinal neurones.
Topics: Action Potentials; Adult; Electric Stimulation; Electromyography; H-Reflex; Humans; Middle Aged; Motor Cortex; Motor Neurons; Movement; Muscles; Neurons, Afferent; Radial Nerve; Synaptic Transmission; Wrist
PubMed: 7853222
DOI: 10.1113/jphysiol.1994.sp020352