Motor Loss Research Articles

Physical training and activity in people with diabetic peripheral neuropathy: A case report

Background: Diabetes mellitus (DM) is the most common endocrine disorder affecting more than 100 million people worldwide, around 6% of the population. This matter characterized by hyperglycemia (high glucose levels in blood) caused by a lack or ineffective production of insulin by the pancreas which results in an increase or decrease in the concentration of glucose in the blood. Diabetic peripheral neuropathy (DPN) or what is called diabetic peripheral neuropathy is the most common complication in cases of diabetes mellitus. DPN is a disease of loss of motor, sensory and autonomic nerve function, which can affect the peripheral nervous system. Sensorimotor training is considered a technique that can improve balance. This emphasizes the function of the sensorimotor system as a unit that works to increase sensory input and motor recruitment patterns in maintaining joint stability and regulating movement through the central nervous system (CNS). Aerobic exercise is a type of physical activity that can prevent and reduce DPN. Aerobic exercise such as treadmill can train balance. Balance training shows a high positive effect on improving motor and sensory symptoms in peripheral neuropathyPurpose: To examine the effects of sensorimotor training and lower limb muscle activity in DPN patients using treadmill.Method: The research uses a case study design, namely a research method that uses various data sources that can be used as research material, describing and explaining comprehensively various aspects of an individual, group, program, organization or event systematically. Participants in this study were patients aged 64 years, female, diagnosed diabetes mellitus type 2 (T2DM) for 10 years by a doctor. This research uses an aspect identification questionnaire instrument. DPN is screened using Michigan Neuropathy Screening Instrument (MNSI). Static balance is determined by romberg test and for dynamic balance it is measured by timed up and go test. Functional lower limb muscle strength is checked using tests Five Time Sit to Stand (5xSST).Results: The data for the respondent is a housewife aged 64 years, last education is junior high school with status as a housewife. The patient suffered from T2DM for 10 years with a hemoglobin 1AC level of 6.8 mg/dl, was overweight as indicated by the patient's BMI of 26 kg/m2. Often feels pain in both legs, when the patient walks and does strenuous activities with a score of 9, and the pain decreases when resting with a score of 3. Apart from that, the patient also has vision problems with a score of 20/40, meaning the patient can only see letters. at a distance of 20 feet. Even though normally letters can be seen clearly, namely 40 feet, this visual disturbance can cause the patient's balance to be disturbed. Providing treatment for 6 weeks can significantly improve the patient's quality of life as seen from the initial WHO QoL score of 58 to 86.Conclusion: Providing treadmill training for 6 weeks carried out 3 times a week showed significant results in reducing hemoglobin levels and DPN scores in T2DM patients.

Juvenile idiopathic epilepsy in Egyptian Arabian foals, a potential animal model of self-limited epilepsy in children.

Juvenile idiopathic epilepsy (JIE) is categorized as a generalized epilepsy. Epilepsy classification entails electrocortical characterization and localization of epileptic discharges (ED) using electroencephalography (EEG). Characterize epilepsy in Egyptian Arabian foals with JIE using EEG. Sixty-nine foals (JIE, 48; controls, 21). Retrospective study. Inclusion criteria consisted of Egyptian Arabian foals: (1) JIE group diagnosed based on witnessed or recorded seizures, and neurological and EEG findings, and (2) control group of healthy nonepileptic age-matched foals. Clinical data were obtained in 48 foals. Electroencephalography with photic stimulation was performed under standing sedation in 37 JIE foals and 21 controls. Abnormalities on EEG were found in 95% of epileptic foals (35 of 37) and in 3 of 21 control asymptomatic foals with affected siblings. Focal ED were detected predominantly in the central vertex with diffusion into the centroparietal or frontocentral regions (n = 35). Generalization of ED occurred in 14 JIE foals. Epileptic discharges commonly were seen during wakefulness (n = 27/37 JIE foals) and sedated sleep (n = 35/37 JIE foals; 3/21 controls). Photic stimulation triggered focal central ED in 15 of 21 JIE foals. Juvenile idiopathic epilepsy has a focal onset of ED at the central vertex with spread resulting in clinical generalized tonic-clonic seizures with facial motor activity and loss of consciousness. Electroencephalography with photic stimulation contributes to accurate phenotyping of epilepsy. Foals with this benign self-limiting disorder might serve as a naturally occurring animal model for self-limited epilepsy in children.

Traumatic lumbar hematomyelia causing spinal shock: A case report

Background: Spinal cord hemorrhage or hematomyelia can arise from trauma or non-trauma causes, adverse effect of anticoagulation therapy and ruptured vascular malformation. Bleeding in epidural space is common and complications such as acute spinal cord syndrome can arise due to the compression and destruction of the spinal cord. Symptoms of hematomyelia might be varied depending on location of the lesion, often accompanied with acute radicular pain. In this case study, we reported a case of spinal shock after traumatic lumbar hematomyelia. Case: A 13-year-old girl presented to Dr. Moewardi General Hospital with inferior paraparesis, bladder and bowel incontinence, a day after falling on her gluteus. Physical examination revealed reduced motoric and sensory function below 12th thoracal dermatome, with no patellar and reduced Achilles reflexes. Conventional X-ray was unremarkable and further investigation with MRI showed a hematoma on thoracal 10 to 12 vertebrae. Motor and sensory functions were improved after 12 days administration of corticosteroids and further improvement was seen almost immediately after decompression surgery. Objective: To describe a case of spinal shock caused by traumatic lumbar hematomyelia Method: This is a case report study describing spinal shock which improved after administration of corticosteroid and decompression surgery. Conclusion: Spinal shock could be caused by traumatic lumbar hematomyelia, which is characterized by loss of motor, sensory, and bladder function, and decompression surgery improved the prognosis.

Development and Validation of Wheelchair-Based Yoga Module for Individuals with Paraplegia.

Spinal cord injury causes temporary or permanent loss of motor, sensory, or autonomic functions, leading to long-term impairments that are not only confined to physical attributes but also restrict individuals' participation in major domains of life. Around 60%-80% of individuals with spinal cord injuries depend on a wheelchair for mobility. Numerous studies have reported yoga's beneficial role in alleviating spinal cord injury symptoms; however, a validated wheelchair-based yoga module was unavailable. Thus, the present study aimed to develop and validate a wheelchair-based yoga module that comprises a printed protocol for individuals with paraplegia. The study was conducted in four phases: The first three phases were the steps for the formulation of a wheelchair-based yoga module, and in the last phase the content validity of the designed module was determined by a panel of 10 experts, who were asked to rate the preliminary module for its necessity and relevance using a Likert scale. A total of 17 yoga practices with high content validity were included in the final wheelchair-based yoga module, and 10 practices with lower content validity were excluded from the designed module. Data analysis revealed the mean content validation index of the designed module to be 0.81. This study concludes that the formulated wheelchair-based yoga module is valid for individuals with paraplegia. However, future studies need to be conducted to determine the protocol's feasibility and effectiveness.

MODERNIZATION OF THE ELECTRIC DRIVE OF PUMPING UNITS OF THE DISTRICT HEATING NETWORK IN THE CONTEXT OF INCREASING THEIR ENERGY EFFICIENCY

Quantitative and qualitative indicators of the modernization of the electric drive of a pumping unit of a network with throttle control of the coolant supply of a centralized heat supply system are determined. The possibility of modernizing the electric drive by replacing outdated electric motors of energy efficiency class IE1, which are still used in electric drives of pumping units, with electric motors of energy efficiency classes IE2 and IE3 from different manufacturers, has been substantiated. The energy consumption was calculated based on the technical data of the pump and electric motors provided by the manufacturers and includes the calculation of the energy consumption of pumping units in a typical operating cycle typical for district heating networks, which involves operation at reduced load for a long time. Comparative calculated data on the daily and annual energy consumption of the considered electric motors in a typical operating cycle of a pumping unit, with respect to the least energy-efficient electric motor among those considered, were obtained. The practical significance of the results obtained is to understand that the selection of an electric motor by efficiency at variable load, i.e., actually on the basis of the IE energy efficiency class assigned in accordance with the IEC 60034-30-1 standard, is incorrect, It is substantiated that the choice should be made using the efficiency interpolated by the method of polynomial interpolation of the motor loss curve, while taking into account the economic feasibility of choosing an electric motor between energy efficiency classes, in this case IE2 and IE3, and different manufacturers.

Increased Dynamic Drivetrain Performance by Implementing a Modular Design with Decentralized Control Architecture

This paper assesses the energy consumption, control performance, and application-specific functional requirements of a modular drivetrain in comparison to a benchmark drivetrain. A decentralised control architecture has been developed and validated using mechanical plant models. Simscape models have been validated with data from an experimental setup including an equivalent modular and benchmark drivetrain. In addition, the control strategy has been implemented and validated on the experimental setup. The results prove the ability of the control strategy to synchronize the motion of the different sliders, resulting in crank position tracking errors below 0.032 radians on the setup. The model and experimental data show an increased performance of the modular drivetrain compared to the benchmark drivetrain in terms of energy consumption, control performance, and functional requirements. The modular drivetrain is especially advantageous for machines running highly dynamic motion profiles due to the reduced inertia. For such motion profiles, an increased position tracking of up to 84% has been measured. In addition, it is shown that the modular drivetrain root mean square (RMS) torque is reduced with 32% compared to the benchmark drivetrain. However, these mechanical energy savings are partly counteracted by the higher motor losses seen in the modular drivetrain, resulting in potential electrical energy savings of around 29%.

Application of Injectable Hydrogels as Delivery Systems in Spinal Cord Injury.

Spinal cord injury (SCI) is a severe neurological injury caused by traffic accidents, trauma, or falls, which leads to significant loss of sensory, motor, and autonomous functions and seriously affects the patient's life quality. Although considerable progress has been made in mitigating secondary injury and promoting the regeneration/repair of SCI, the therapeutic effects need to be improved due to drug availability. Given their good biocompatibility, biodegradability, and low immunogenicity, injectable hydrogels can be used as delivery systems to achieve controlled release of drugs and other substances (cells and proteins, etc.), offering new hope for SCI repair. In this article, we summarized the types of injectable hydrogels, analyzed their application as delivery systems in SCI, and further discussed the mechanisms of hydrogels in the treatment of SCI, such as anti-inflammatory, antioxidant, anti-apoptosis, and pro-neurogenesis. Moreover, we highlighted the potential benefits of hydrogels in the treatment of SCI in combination with therapies, including the recent advances and achievements of these promising tools. Our review may offer new strategies for the development of SCI treatments based on injectable hydrogels as delivery systems.

DLPformer: A Hybrid Mathematical Model for State of Charge Prediction in Electric Vehicles Using Machine Learning Approaches

Accurate mathematical modeling of state of charge (SOC) prediction is essential for battery management systems (BMSs) to improve battery utilization efficiency and ensure a good safety performance. The current SOC prediction framework only considers battery-related features but ignores vehicle information. Additionally, in light of the emergence of time-series Transformers (TSTs) that harness the power of multi-head attention, developing a SOC prediction model remains a significant challenge. Therefore, we introduce a new framework that integrates laboratory battery data with mathematical vehicle model features to improve the accuracy of the SOC and propose a prediction model named DLPformer, which can effectively capture variations in the SOC attributed to both trend and seasonal patterns. First, we apply Matlab/Simulink to simulate a mathematical model of electric vehicles and process the generated vehicle data with Spearman correlation analysis to identify the most relevant features, such as the mechanical losses of the electric motor, differential, and aerodynamic drag. Then, we employ a data fusion method to synchronize the heterogeneous datasets with different frequencies to capture the sudden changes in electric vehicles. Subsequently, the fused features are input into our prediction model, DLPformer, which incorporates a linear model for trend prediction and patch-input attention for seasonal component prediction. Finally, in order to effectively evaluate the extrapolation and adaptability of our model, we utilize different driving cycles and heterogeneous battery datasets for training and testing. The experimental results show that our prediction model significantly improves the accuracy and robustness of SOC prediction under the proposed framework, achieving MAE values of 0.18% and 0.10% across distinct driving cycles and battery types.

Resveratrol improves the prognosis of rats after spinal cord injury by inhibiting mitogen-activated protein kinases signaling pathway

Spinal cord injury (SCI) is a serious condition that results in irreparable nerve damage and severe loss of motor or sensory function. Resveratrol (3,4′,5-trihy- droxystilbene) is a naturally occurring plant-based polyphenol that has demonstrated powerful antioxidative, anti-inflammatory, and anti-carcinogenic pharmaceutical properties in previous studies. In the central nervous system, it promotes neuronal recovery and protects residual function. However, the role of resveratrol in SCI recovery remains elusive. In this study, the potential mechanisms by which resveratrol affect SCI in rats were assessed by constructing a contusion model of SCI. Resveratrol was intraperitoneally administered to rats. Behavioral scores and electrophysiological examinations were performed to assess functional recovery. After magnetic resonance imaging and staining with hematoxylin and eosin (HE) and Luxor Fast Blue (LFB), tissue recovery was analyzed. Immunofluorescence with NeuN and glial fibrillary acidic protein (GFAP) was employed to evaluate neuronal survival and glial changes. TdT-mediated dUTP nick end labeling (TUNEL) assay was performed to examine apoptotic rates. Moreover, network pharmacology was performed to identify relevant pathways of resveratrol for the treatment of SCI. Lastly, ELISA was performed to detect the expression levels of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and IL-6. Our findings revealed that resveratrol dramatically improved the hindlimb locomotor function and their electrophysiological outcomes. Notably, lesion size was significantly reduced on magnetic resonance imaging. HE and LFB staining exposed increased sparseness of tissue and myelin. GFAP and NeuN immunofluorescence assays at the lesion site determined that resveratrol boosted neuronal survival and attenuated glial cell overgrowth. In addition, resveratrol reduced the density and number of TUNEL-positive cells in rats after injury. Additionally, gene ontology analysis revealed that the enriched differentially expressed protein was associated with the JNK/p38MAPK (c-jun N-terminal kinase/p38 mitogen-activated protein kinase) signaling pathway. Following resveratrol treatment, the expression levels of IL-1β, TNF-α, and IL-6 were decreased. In summary, the administration of resveratrol protects motor function and neuronal survival in rats after SCI. Furthermore, resveratrol exerts an anti-inflammatory effect by blocking the JNK/p38MAPK signaling pathway.

Energy-saving starting method of electric motor based on the battery-accumulator hybrid drive

The series electro-hydraulic hybrid powertrain has advantages in improving the dynamic characteristics and increasing the cruising range of battery rail vehicles. In order to reduce the large peak starting current of electric motor, an energy-saving starting method is proposed, which is using the hydraulic pump/motor to reversely drive the electric motor to restart at a speed, based on the energy reverse transfer characteristics between electric motor and hydraulic pump/motor. Firstly, the principle of restarting the electric motor at a speed is proposed based on the designed EH3. Then, PID is adopted to control the starting of electric motor which is driven by hydraulic powertrain. And a speed sensorless control algorithm is designed to control the restarting at a speed. Finally, aiming at the problem that the traditional simulation models of electro-hydraulic hybrid powertrain components are too simple and ideal. The estimation model of battery and SOC, dynamic efficiency model of hydraulic motor and dynamic iron loss model of PMSM are improved and optimized to improve the accuracy of powertrain simulation. The results both of co-simulation and experiments shows that the starting current can be reduced by 69.36 % at most and 64.91 % of battery consumption can be saved by restarting the electric motor at a speed.

Navigating an emotional journey: A qualitative study of the emotional experiences of family carers currently supporting people living with motor neurone disease.

Family carers of people living with motor neurone disease (MND) face continuous changes and losses during the progression of the disease, impacting on their emotional wellbeing. Carers' emotions might affect their engagement in everyday activities and their caring role. However, how carers manage their emotions and which strategies they identify as useful to cope with them while caring is under researched. To identify the emotional experiences and coping strategies of MND family carers while caring the person living with MND. We conducted 14 semi-structured interviews with family carers currently supporting people living with MND living in the UK. Interviews were audio/video recorded and professionally transcribed verbatim. We analyzed data inductively within an interpretive descriptive approach, using reflexive thematic analysis. Three key themes were generated from the analysis. Destabilization of diagnosis reflected the devastating impact the diagnosis had on carers, characterized by initial overwhelming emotions. Adapting to new circumstances and identifying coping strategies captured how carers experienced everyday changes and losses and how they gradually adjusted to the situation by identifying coping strategies to be able to manage arising emotions. Maintaining emotional coping encompassed how carers used individual strategies they had tried before and had worked for them to cope emotionally with the continuous changes and losses while preserving their emotional wellbeing. Our findings suggest that carers of people living with MND embark on an emotional journey from the diagnosis of the disease. As the disease progresses, carers adopt coping strategies that best work for them to manage their emotions (e.g., living day by day and seeking support). Understanding the key strategies used to support emotional coping during the caring journey and how carers re-construct their emotional life around MND could help inform future practice and research to better support carers of this population.

Research on Rotor Loss and Rotor Structure Optimization of Rare Earth Permanent Magnet Synchronous Motors in the Weak Field Area

The rotor loss of rare earth permanent magnet synchronous motor (PMSM) affects the efficiency and reliability of the motor and is an important research direction of rare earth permanent magnet synchronous motors. In this paper, the influence of rotational speed on the loss of the rotor core and the permanent magnet is analyzed through the analysis of the motor magnetic field and rotor loss calculation. Specifically, with the increase in rotational speed, the weak magnetic current increases, the amplitude of flux density change in the rotor core decreases, and the loss of the rotor core also decreases. The greater the influence of the harmonic current magnetic field on the outside of the rotor, the greater the loss. The core loss on the rotor is mainly distributed on the outside of the rotor. For further engineering applications, this paper analyzes the loss composition of three kinds of motors with different rotor structures and judges the optimal scheme based on the minimum loss. Finally, the correctness of this research is verified by comparing the experimental and simulation results of two kinds of motors with different rotor structures. The research content of this paper can provide a reference for the loss analysis and optimization and rotor structure selection of rare earth permanent magnet synchronous motor rotor design.

Effect of Permanent Magnet Segmentation Structure on Eddy Current Loss of Permanent Magnet Synchronous Motor

For this essay, the mechanism of cutting a magnet to reduce its loss is investigated using the equivalent circuit of magnet segmentation, and the method is verified by the finite element method. The results indicate that the segmentation of magnets can effectively reduce the eddy current loss of magnets. The larger the product of segmented lengths is, the smaller the eddy current loss is. The higher the number of segments is, the lower of loss value is. The rotational speed and eddy current loss are in the square. Load multiple and eddy current loss is in cubic growth.

Investigation on the Influence of Eccentricity on the AC Copper Loss of High-Speed Slotless Permanent Magnet Motor

The armature winding of slotless motor is directly exposed to the air gap magnetic field. During high speed operation, the effective part of the armature winding cuts the flux lines directly, which would inevitably cause large AC copper loss. Moreover, when the rotor is eccentric, appreciable distortions would be appeared in the air gap flux density. The additional flux density would aggravate the AC copper loss. In this paper, the mechanism of AC copper loss of high speed slotless motors is explained firstly. Then the influence of eccentricity on AC copper loss is evaluated. Finally, the difference in the effect of dynamic and static eccentricity on AC copper loss is compared.

A Novel Fault Tolerance Structure of Arc Linear Flux Switching Permanent Magnet Motors Based on Redundant Winding

This paper presents a novel structure of the arc linear flux switching permanent magnet motor based on the redundant winding to inhibit the rises of the motor losses and temperature due to the open circuit fault tolerance. Firstly, the structural characteristic of the arc linear flux switching permanent magnet motor is introduced. Then, the fault tolerance current of single phase open circuit fault is calculated for different winding connection forms. The fault tolerance performances under different conditions are compared from a special view of motor temperature rises. Finally, a novel structure for fault tolerance enhancement is proposed, which can effectively improve the freedom degree of the fault tolerance current by using the redundant winding. This novel structure takes full advantage of the circumferential air gap between the arc stator. The calculation results show that the novel structure can allow the fault tolerance of open circuit fault has little influence on the motor copper losses and temperature rises while maintaining the on-load torque.

Hydrogel and Nanomedicine-Based Multimodal Therapeutic Strategies for Spinal Cord Injury.

Spinal cord injury (SCI) is a severe neurodegenerative disease caused by mechanical and biological factors, manifesting as a loss of motor and sensory functions. Inhibition of injury expansion and even reversal of injury in the acute damage stage of SCI are important strategies for treating this disease. Hydrogels and nanoparticle (NP)-based drugs are the most effective, widely studied, and clinically valuable therapeutic strategies in the field of repair and regeneration. Hydrogels are 3D flow structures that fill the pathological gaps in SCI and provide a microenvironment similar to that of the spinal cord extracellular matrix for nerve cell regeneration. NP-based drugs can easily penetrate the blood-spinal cord barrier, target SCI lesions, and are noninvasive. Hydrogels and NPs as drug carriers can be loaded with various drugs and biological therapeutic factors for slow release in SCI lesions. They help drugs function more efficiently by exerting anti-inflammatory, antioxidant, and nerve regeneration effects to promote the recovery of neurological function. In this review, the use of hydrogels and NPs as drug carriers and the role of both in the repair of SCI are discussed to provide a multimodal strategic reference for nerve repair and regeneration after SCI.

Treatment of intramedullary spinal cord tumors: a modified Delphi technique of the North American Spine Society Section of Spine Oncology.

Intramedullary spinal cord tumors (IMSCTs) are rare tumors with heterogeneous presentations and natural histories that complicate their management. Standardized guidelines are lacking on when to surgically intervene and the appropriate aggressiveness of resection, especially given the risk of new neurological deficits following resection of infiltrative tumors. Here, the authors present the results of a modified Delphi method using input from surgeons experienced with IMSCT removal to construct a framework for the operative management of IMSCTs based on the clinical, radiographic, and tumor-specific characteristics. A modified Delphi technique was conducted using a group of 14 neurosurgeons experienced in IMSCT resection. Three rounds of written correspondence, surveys, and videoconferencing were carried out. Participants were queried about clinical and radiographic criteria used to determine operative candidacy and guide decision-making. Members then completed a final survey indicating their choice of observation or surgery, choice of resection strategy, and decision to perform duraplasty, in response to a set of patient- and tumor-specific characteristics. Consensus was defined as ≥ 80% agreement, while responses with 70%-79% agreement were defined as agreement. Thirty-six total characteristics were assessed. There was consensus favoring surgical intervention for patients with new-onset myelopathy (86% agreement), chronic myelopathy (86%), or progression from mild to disabling numbness (86%), but disagreement for patients with mild numbness or chronic paraplegia. Age was not a determinant of operative candidacy except among frail patients, who were deemed more suitable for observation (93%). Well-circumscribed (93%) or posteriorly located tumors reaching the surface (86%) were consensus surgical lesions, and participants agreed that the presence of syringomyelia (71%) and peritumoral T2 signal change (79%) were favorable indications for surgery. There was consensus that complete loss of transcranial motor evoked potentials with a 50% decrease in the D-wave amplitude should halt further resection (93%). Preoperative symptoms seldom influenced choice of resection strategy, while a distinct cleavage plane (100%) or visible tumor-cord margins (100%) strongly favored gross-total resection. The authors present a modified Delphi technique highlighting areas of consensus and agreement regarding surgical management of IMSCTs. Although not intended as a substitute for individual clinical decision-making, the results can help guide care of these patients. Additionally, areas of controversy meriting further investigation are highlighted.

Evaluation of Asynchronous Traction Motor Losses when Operating from a Frequency Converter

Evaluation of Asynchronous Traction Motor Losses when Operating from a Frequency Converter

Contralateral cervical 7 as a potential donor in nerve transfer of adult brachial plexus injury especially in root avulsion case: A case report

Introduction: Contralateral cervical 7 (CC7) nerve transfer can be used in the absence of neurotizer in the BPI total root avulsion case. CC7 nerve transfer was introduced by Gu et al. in 1986, and aimed to restore motor and sensory function in the hand. The purpose of this paper is to report BPI patients with nearly total root avulsion using CC7 nerve transfer to the median nerve. Case Presentation: A man suffered a motorcycle accident in March 2010. There was a complete loss of motor and sensory in the right upper limb. From the examination, it was obtained that the cervical root avulsion of C5-6, C7 postganglionic rupture and cervical root avulsion of C8-T1. In April of 2010 has been done root neurotization C4 to C5, C3 root neurotization was to the suprascapular nerve, neurotization of the phrenic nerve to C6, neurotization C7 to C6 with graft, and neurotization CC7 to median nerve with vascularized pedicle ulnar graft. An evaluation was made at the donor and recipient sites. From the first admission he had total motoric loss to the last evaluation for 5 years post operation of motoric in the recipient site showed range of motion (ROM) of elbow flexion recovered to M4 with ROM 135o, shoulder abduction reached M3 30 o, finger flexion recovered to M2, and hand sensation came up to S1. There was no morbidity on the donor site from the first evaluation. Conclusion: Therefore, CC7 can be a potential donor in nerve transfer of adult BPI root avulsion cases without causing morbidity in the donor site.

Asserting a Functional Neurological Symptom Disorder with a Complementary Diagnostic Approach: A Brief Report.

Functional neurological symptom disorder (FNSD) is a common diagnosis among adolescents. However, we feel it is a difficult diagnosis to assess because of the diversity of its clinical manifestations, the rapid changes in its nosography over the years, and its common imbrication with established somatic diagnoses. We would like to illustrate this hypothesis through a case presentation and the original diagnostic process that emerged from it. We chose to present our diagnosis approach through the case of an 11-year-old boy who showed a progressive loss of motor and sensory function to the point of total dependency, and then suddenly switched between this state and a "normal" physical presentation, while deliriously claiming to be an angel. All possible infectious, autoimmune, metabolic, and toxic disorders were ruled out. After the successive therapeutic failures of antidepressants and neuroleptics, FNSD was diagnosed. The DSM-5-TR classification was insufficient to explain the full clinical picture and a complementary approach (biblical, psychoanalytical, and historical) was used to analyze the cause of this atypical presentation.