Neurolymphomatosis is the direct endoneurial infiltration of lymphoma cells. Bone marrow biopsy is a widely practiced procedure that is generally considered to be relatively safe. However, bone marrow biopsy can also result in pain and long-term consequences such as nerve injury. Here we report a case of a 68-year-old male who presented with lumbosacral plexopathy due to neurolymphomatosis that was superimposed on a probable traumatic lumbosacral plexopathy mostly involving the sciatic nerve immediately after a bone marrow biopsy.
Ultrasonography is currently being developed as a tool for evaluating peripheral neuropathy. It is one of the painless and least-invasive methods of medical diagnostic testing that yields anatomic views of the nerves and their surrounding structures. Here I first describe the equipment settings and technique for nerve ultrasound along with typical sonographic findings for normal nerves. I then address frequently used parameters for nerve measurements that facilitate diagnoses of focal and generalized neuropathies.
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Muscle and nerve biopsy may be vital diagnostic tools in various neuromuscular disorders. Since these procedures are invasive, it matters to decide when to perform a biopsy, which muscle or nerve to be selected, and how to interpret the pathologies. This review addresses the indications, methods of biopsies, and also significant pathological findings frequently encountered in muscle and nerve pathology.
Suk-Won Ahn, Byung-Nam Yoon, Jee-Eun Kim, Jin Myoung Seok, Kwang-Kuk Kim, Young Min Lim, Ki-Han Kwon, Kee Duk Park, Bum Chun Suh, on behalf of the Korean Society of Clinical Neurophysiology Education Committee
Ann Clin Neurophysiol 2018;20(2):71-78. Published online July 31, 2018
Nerve conduction study (NCS) is an electrophysiological tool to assess the overall function of cranial and peripheral nervous system, therefore NCS has been diagnostically helpful in the identification and characterization of disorders involving nerve roots, peripheral nerves, muscle and neuromuscular junction, and are frequently accompanied by a needle Electromyography. Furthermore, NCS could provide valuable quantitative and qualitative results into neuromuscular function. Usually, motor, sensory, or mixed nerve studies can be performed with using NCS, stimulating the nerves with the recording electrodes placed over a distal muscle, a cutaneous sensory nerve, or the entire mixed nerve, respectively. And these findings of motor, sensory, and mixed nerve studies often show different and distinct patterns of specific abnormalities indicating the neuromuscular disorders. The purpose of this special article is to review the neurophysiologic usefulness of NCS, to outline the technical factors associated with the performance of NCS, and to demonstrate characteristic NCS changes in the setting of various neuromuscular conditions.
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Background It is generally accepted that upper motor neuron (UMN) lesion can alter lower motor neuron (LMN) functionby the plasticity of neural circuit. However there have been only few researches regarding the axonal excitability of LMNafter UMN injury especially during the acute stage. The aim of this study was to investigate the nerve excitability propertiesof the LMNs following an acute to subacute supratentorial corticospinal tract lesion. Methods: An automated nerve excitabilitytest (NET) using the threshold tracking technique was utilized to measure multiple excitability indices in median motoraxons of 15 stroke patients and 20 controls. Testing of both paretic and non-paretic side was repeated twice, during theacute stage and subacute stage. The protocols calculated the strength-duration time constant from the duration?릀harge curve,parameters of threshold electrotonus (TE), the current-threshold relationship from sequential sub-threshold current, and therecovery cycle from sequential supra-threshold stimulation. Results: On the paretic side, compared with the control group,significant decline of superexcitablity and increase in the relative refractory period were observed during the subacute stageof stroke. Additionally, despite the absence of statistical significance, a mildly collapsing in (
The pathomechanisms involved in both restless legs syndrome (RLS) and complex regional pain syndrome type I(CRPS I) are still controversial whether they are central or peripheral origins. We recently encountered a patient whohad an unusual coexistence of both RLS and CRPS I, and both of which showed good responses to sympathetic block.These findings suggest the role of peripheral mechanisms, especially unmyelinated small autonomic fiber, in both RLSand CRPS I