Results Of Electrophysiologic Testing Research Articles

The effect of silicone oil on the anatomical and functional parameters of the retina during surgery of regmatogenic retinal detachment

Vitrectomy followed by endotamponade of the vitreal cavity with silicone oil (SO) is one of the main techniques of treating severe forms of regmatogenic retinal detachment (RRD). Endotamponade with SO, having numerous advantages and a huge potential, carries the risk of a number of complications arising at various times of application. The literature review analyzes the published data on the effect of tamponade SO on the retina and the function of central vision in RRD surgery: visual acuity, indicators of light and color sensitivity, data of electrophysiological test results. Possible causes of deteriorated central vision functions directly or indirectly related to tamponade with SO are discussed: changes in the thickness and structure of the retina or its individual layers as shown by optical coherence tomography (OCT) data, microcirculation disorders according to OCT angiography, fluorescein angiography, Doppler laser scanning, as well as pathohistological findings related to SO migration into the fundus of eye tissues.

Melatonin regulates microglial polarization to M2 cell via RhoA/ROCK signaling pathway in epilepsy.

Melatonin (MEL), an endogenous hormone, has been widely investigated in neurological diseases. Microglia (MG), a resident immunocyte localizing in central nervous system is reported to play important functions in the animal model of temporal lobe epilepsy (TLE). Some evidence showed that MEL influenced activation of MG, but the detailed model of action that MEL plays in remains uncertain. In this study, we established a model of TLE in mice by stereotactic injection of kainic acid (KA). We treated the mice with MEL. Lipopolysaccharide, ROCK2-knockdown (ROCK-KD) and -overexpression (ROCK-OE) of lentivirus-treated cells were used in cell experiments to simulate an in vitro inflammatory model. The results of electrophysiological tests showed that MEL reduced frequency and severity of seizure. The results of behavioral tests indicated MEL improved cognition, learning, and memory ability. Histological evidences demonstrated a significant reduction of neuronal death in the hippocampus. In vivo study showed that MEL changed the polarization status of MG from a proinflammatory M1 phenotype to an anti-inflammatory M2 phenotype by inversely regulating the RhoA/ROCK signaling pathway. In cytological study, we found that MEL had a significant protective effect in LPS-treated BV-2 cells and ROCK-KD cells, while the protective effect of MEL was significantly attenuated in ROCK-OE cells. MEL played an antiepileptic role in the KA-induced TLE modeling mice both in behavioral and histological levels, and changed MG polarization status by regulating the RhoA/ROCK signaling pathway.

Prospective Assessment of Risk Factors Influencing Facial Nerve Paresis in Patients after Surgery for Parotid Gland Tumors.

Background and objectives: Facial weakness is the most important complication of parotid gland tumor surgery. The aims of this study are as follows: (1) assessment of the prevalence of postparotidectomy facial nerve dysfunction; (2) clinical and electrophysiological assessment of the facial nerve function before parotidectomy and at 1 and 6 months postoperatively; (3) assessment of the association of postoperative facial palsy with selected risk factors; and (4) assessment of the correlation between the results of clinical and neurophysiological assessments of facial nerve function. Materials and Methods: This study comprised 50 patients (aged 24-75 years) who underwent parotidectomy at the Department of Otolaryngology and Laryngological Oncology in Zabrze, Poland between 2015 and 2017. The evaluation included neurological, clinical and electrophysiological assessments of the facial nerve prior to surgery and at 1 and 6 months postoperatively. Results: No facial palsy was found preoperatively or 6 months postoperatively. Facial nerve dysfunction was found in 74% of patients 1 month postoperatively. In most cases (54%), paresis was mild or moderate (House-Brackmann grades II and III). The results of electrophysiological tests before parotidectomy were either normal or showed some mild abnormalities. We found a statistically significant correlation between the clinical assessment of the facial nerve function (based on the House-Brackmann scale) one month postoperatively and the latency of the CMAP response from the orbicularis oculi and orbicularis oris muscles. In all three studies, a statistically significant correlation was found between the amplitude of the compound muscle action potential (CMAP) of the orbicularis oris muscle and the degree of facial nerve weakness. Conclusions: The factors that may influence the risk of postoperative facial nerve paralysis (prolonged surgical time and the size and location of the tumor other than in the superficial lobe only) may indirectly suggest that surgery-related difficulties and/or surgeon experience could be crucial to surgery safety.

Comparison of characteristics between neuropathic pain and non-neuropathic pain in patients with diabetic carpal tunnel syndrome: A cross-sectional study

BackgroundThe aim of the study was to compare the clinical characteristics of diabetic carpal tunnel syndrome between patients with neuropathic pain (NeuP) and non-NeuP.MethodsWe enrolled 276 patients with diabetic carpal tunnel syndrome. Pain symptoms were evaluated using a visual analog scale. Douleur Neuropathique 4, the Neuropathic Pain Symptoms Inventory questionnaire, and the body map were used to assess neuropathic symptoms. Baseline information, clinical manifestations, electrophysiological test results, and psychological status were compared between the neuropathic pain (NeuP) and non-NeuP to identify the risk factor for NeuP occurrence.ResultsResults showed that the degree of pain was more severe in NeuP patients than in nociceptive pain patients (p = 0.025). The frequencies of light touch and pinprick were more pronounced in the NeuP group than in the non-NeuP group (light touch: p = 0.001; pinprick: p = 0.004). There were 48 and 27 NeuP patients with extramedian and proximal spread, respectively, whereas in the non-NeuP group, there were 11 and 9 patients, respectively (p = 0.03). Electrophysiological results showed that patients in the NeuP group exhibited greater sensory nerve conduction velocity impairment compared with the non-NeuP group (p = 0.033). Pain Catastrophizing Scale total scores of the NeuP group were significantly higher than those of the non-NeuP group (p = 0.006).ConclusionOf the 276 diabetic carpal tunnel syndrome patients studied, the majority had NeuP. Furthermore, light touch, electrophysiological test results, and psychological factors were found to be related to NeuP occurrence in patients with diabetic carpal tunnel syndrome.

Supraventicular tachycardia and atrial ectopic beats: electrophysiological findings in a patient after previous slow pathway ablation

In this case report we present electrophysiological features of supraventricular tachycardia in a 64-year-old patient after previous slow pathway catheter ablation; ECG features of the tachycardia and results of electrophysiological testing are discussed.

The development, validity, reliability, and norm of a preschool auditory processing assessment scale in China

BackgroundChildren with auditory processing deficits may face problems with language, learning, and social communication. AimsTo develop a Chinese auditory processing assessment scale for preschool children and establish the norms of the scale. Methods and proceduresThe predictive version of the scale was formed by a literature review, qualitative interviews, expert consultation, and a pre-test with a small sample. Nine kindergartens in Nanjing were selected by a stratified cluster sampling plan. First, 734 children from two kindergartens were selected for the large sample pre-test of the scale. Then, 1526 children from four kindergartens and 1151 children from three kindergartens were selected for the reliability and validity analysis and confirmatory factor analysis, respectively. The standardized norm data of the scale were established based on the 3411 points of scale data of the nine kindergartens. Finally, the clinical usefulness of the scale was analyzed by comparing the results of objective auditory processing tests in children with normal and abnormal auditory processing prompted by the score on the scale. Outcomes and resultsThe preschool auditory processing assessment scale includes 5 dimensions and 30 items. The Cronbach's alpha value of the scale is greater than 0.9. The confirmatory factor analysis results verify that the scale structure is reasonable. The percentile norm of the scale was established. The results of electrophysiological tests of the normal and abnormal auditory processing groups were statistically different (P < 0.05). Conclusions and implicationsThe developed preschool auditory processing assessment scale has good reliability and validity. The scale is suitable for clinical application.

Plant volatile organic compounds attractive to Lygus pratensis.

Lygus pratensis, an important agricultural pest, is seriously detrimental to cotton in China. For the research and development of attractants, the present study screened and identified plant volatiles with activity against the pest. Out of the total 20 volatiles identified from seven hosts, 16 volatiles were selected and evaluated. Electrophysiological test results revealed the highest electroantennogram values of heptacosane, heptadecane, decanal, (E)-4-hexen-1-ol, dodecane, β-pinene, and cis-3-hexenyl isovalerate on adult insects. A significant difference in the behavior of female adults (P < 0.01) was noted in the trend behavioral tests when the concentration of heptacosane, nonadecane, heptadecane, decanal, 3-hexen-1-ol, and dodecane was 10−3 (V/V), and that of β-pinene was 10−4 (V/V). The field trapping test confirmed a significant difference in the trapping effect of heptadecane at 10−2 (V/V) and 10−3 (V/V), decanal at 10−1 (V/V) and 10−3 (V/V), β-pinene at 10−2 (V/V), and dodecane at 10−4 (V/V) compared to that of other volatiles (P < 0.05). These findings suggested the strong attractant effect of heptadecane, dodecane, decanal, and β-pinene on adults, indicating their potential application as effective attractants for the ecological control of L. pratensis.

Application of ABR in pathogenic neurovascular compression of the 8th cranial nerve in vestibular paroxysmia

PurposeTo investigate the clinical value of electrophysiological tests in indicating pathogenic vascular contact of the 8th nerve in definite vestibular paroxysmia (VP) cases to provide a reference for decompression surgery.MethodsWe retrospectively analyzed patients who had vertigo, unilateral tinnitus, or hearing loss and exhibited vascular contact of the 8th cranial nerve by MRI. Participants were classified into the VP or non-VP group according to the criteria of the Bárány Society in 2016. The demographic characteristics and audiological and electrophysiological test results of the two groups were compared. Receiver operating characteristic (ROC) curves were calculated for ABR to determine the best parameters and cutoff values to predict the existence of pathological neurovascular contact in VP.ResultsThirteen patients in the VP group and 66 patients in the non-VP group were included. VP patients had longer interpeak latency (IPL) I–III and wave III latency compared to non-VP patients (p < 0.001; p < 0.001). According to the ROC analyses, IPL I–III and wave III latency were the best indicators for the diagnosis of VP. The optimal cutoff for IPL I–III was 2.3 ms (sensitivity 84.6%, specificity 95.5%), and that for wave III latency was 4.0 ms (sensitivity 92.3%, specificity 77.3%). There were no differences in the PTA, caloric test, o-VEMP, or c-VEMP results between the two groups.ConclusionProlonged IPL I–III and the wave III latency of ABR strongly suggested that vascular contact of the 8th cranial nerve was pathological, which may provide some references for microvascular decompression surgery of VP.

Visual Dysfunction In Recent Onset Diabetes: A Clinical Report

A clinical report is presented of a 64 year old patient with recent onset diabetes. Simple in-office test proce­dures for the detection of subtle func­tional abnormalities in the visual system are presented. Diagnostic findings are expanded by results of electrophysiological testing, and com­plemented by an investigation of vas­cular structural integrity by fluorescein angiography. The importance of an examination routine consisting of an assessment of both functional and structural aspects of the visual ele­ments typically affected by the diabetic condition is emphasized.

COVID-19-associated myoclonus in aseries of five critically ill patients.

BackgroundIn addition to respiratory symptoms, many patients with coronavirus disease 2019 (COVID-19) present with neurological complications. Several case reports and small case series described myoclonus in five patients suffering from the disease. The purpose of this article is to report on five critically ill patients with COVID-19-associated myoclonus.Material and methodsThe clinical courses and test results of patients treated in the study center ICU and those of partner hospitals are described. Imaging, laboratory tests and electrophysiological test results are reviewed and discussed.ResultsIn severe cases of COVID-19 myoclonus can manifest about 3 weeks after initial onset of symptoms. Sedation is sometimes effective for symptom control but impedes respiratory weaning. No viral particles or structural lesions explaining this phenomenon were found in this cohort.ConclusionMyoclonus in patients with severe COVID-19 may be due to an inflammatory process, hypoxia or GABAergic impairment. Most patients received treatment with antiepileptic or anti-inflammatory agents and improved clinically.

Peripheral Nerve Regeneration with 3D Printed Bionic Scaffolds Loading Neural Crest Stem Cell Derived Schwann Cell Progenitors

AbstractPeripheral nerve injuries are one of the most common types of traumatic damage to the nervous system. Treatment of peripheral nerve injuries aims to promote axon regrowth by imitating and improving the microenvironment for sciatic nerve regeneration. In this study, regeneration efficiency and behavior of peripheral nerves are compared under three treatment strategies: 1) transplantation of Schwann cell progenitors induced from purified neural crest stem cells; 2) implantation of a multiscale scaffold based on high‐resolution 3D printing; and 3) implantation of this bionic scaffold loading Schwann cell progenitors. The results of structural, electrophysiological, and behavioral tests demonstrate that the three treatment strategies result in different degrees of regeneration. The purified neural crest stem cells differentiate into functional Schwann cells and promote axon regeneration. The multifunctional 3D printed scaffold promotes oriented growth and myelination, and the myelinated nerve regrows with increased density and without visible scaffolds after six months. For the regeneration, scaffold treatment produces better performance than cell graft alone. Finally, it is shown that implantation of multiscale scaffolds preloaded with neural crest stem cell derived Schwann cell progenitors is the best strategy to promote peripheral nerve regeneration with improved anatomy and function among the three different strategies.

B-scan ultrasound, visual electrophysiology and perioperative videoendoscopy for predicting functional results in keratoprosthesis candidates

Background/AimsWe analysed the ability of B-scan ultrasound, ocular electrophysiology testing and videoendoscopic examination for predicting visual prognosis in Boston Type 1 keratoprosthesis (KPro-1) candidates. Indirect anatomical and electrophysiological findings and...

MuSK-Associated Myasthenia Gravis: Clinical Features and Management.

Muscle-specific tyrosine kinase (MuSK) myasthenia gravis (MG) is a rare, frequently more severe, subtype of MG with different pathogenesis, and peculiar clinical features. The prevalence varies among countries and ethnic groups, affecting 5–8% of all MG patients. MuSK-MG usually has an acute onset affecting mainly the facial-bulbar muscles. The symptoms usually progress rapidly, within a few weeks. Early respiratory crises are frequent. The disease may lead to generalized muscle weakness up to muscle atrophy. The main bulbar involvement, the absence of significant thymus alterations, and the association with HLA class II DR14, DR16, and DQ5 alleles have been confirmed. Atypical onset, such as ocular involvement, lack of symptom fluctuations, acetylcholinesterase inhibitors failure, and negative results of electrophysiologic testing, if not specifically performed in the mainly involved muscle groups, makes MuSK-MG diagnosis challenging. In most cases, steroids are effective. Conventional immunosuppressants are not commonly able to replace steroids in maintaining a satisfactory long-term control of symptoms. However, the majority of MuSK-MG patients are refractory to treatment. In these cases, the use of rituximab showed promising results, resulting in sustained symptom control.

Utility of preoperative electrophysiological testing of the facial nerve in patients with vestibular schwannoma.

PurposeThe aim of this study was to analyze the utility of various preoperative electrophysiological tests of the facial nerve CNVII in predicting CNVII function after vestibular schwannoma surgery.MethodsThis retrospective study included 176 patients who had preoperative facial nerve electroneurography and electrically evoked blink reflex testing. We defined the following variables: axonal degeneration of CNVII (AD-CNVII), trigeminal nerve damage (D-CNV), disturbances in the short-latency pathway of the blink reflex (D-BR), and any changes in electrophysiological test results (A-EMG).ResultsAD-CNVII, D-CNV, D-BR, and A-EMG were noted in 24%, 10%, 64%, and 71% of the patients, respectively. Negative D-CNV correlated with good CNVII function in early (p = 0.005) and long-term follow-up (p = 0.003) but was not an independent prognostic factor for postoperative facial muscles function. D-CNV appeared to be closely related to tumor size. D-BR was related to tumor size and had no predictive value. AD-CNVII (amplitude reduction of 50% or more compared to the healthy side) was an independent factor associated with increased risk of facial muscles weakness (p = 0.015 and p = 0.031 for early and late outcomes, respectively).ConclusionsFurther studies are needed to establish which tests and cut-off values are the most useful for predicting post-surgical facial nerve function.

Cardiac Evaluation of Children With a Family History of Sudden Death

BackgroundAfter sudden death occurs in the young, first-degree family members should undergo clinical screening for occult cardiac disease, but the diagnostic yield from screening is not well-defined in the United States. ObjectivesThe purpose of this study was to determine the clinical predictors of cardiac diagnosis in children referred for evaluation following a sudden death in the family. MethodsPatients referred for a family history of sudden death were evaluated in a retrospective review from a tertiary pediatric referral center. ResultsAmong 419 pediatric relatives of 256 decedents, 27% of patients were diagnosed with a disease or had a clinical finding of uncertain significance. Patients were diagnosed with heritable cardiac disease in 39 cases (9.3%). Nonheritable cardiac disease was diagnosed in another 5.5% of patients. Clinical findings of uncertain significance were present in 52 patients (12.4%), including abnormal electrophysiological test results (41 of 52) or imaging test results (11 of 52). Among patients diagnosed with a heritable cardiac disease, the nearest affected relative was almost always a first-degree relative (37 of 39, 95%). The strongest predictors for a successful diagnosis in the patient were an abnormal electrocardiogram and a first-degree relationship to the nearest affected relative (odds ratios: 24.2 and 18.8, respectively). ConclusionsChildren referred for a family history of sudden death receive cardiac disease diagnoses (14%), but clinical findings of uncertain significance increase the challenge of clinical management. The importance of a diagnosis in first-degree affected relatives supports the clinical practice of testing intervening family members first when patients are second- or higher-degree relatives to the decedent.

Therapy of Benign Essential Blepharospasm with Botulinum Toxin

Blepharospasm is a focal dystonia and a rare disease of the brain that causes involuntary spasms of the muscles responsible for eyelid closure. The diagnosis is made clinically and in unclear cases on the basis of results of electrophysiological tests. Therapy of choice consists of local injections with botulinum toxin that have to be repeated on a regular basis.

Missed diagnosis of chronic inflammatory demyelinating polyneuropathy in a patient with cervical myelopathy due to ossification of posterior longitudinal ligament.

In the current study, we report a missed diagnosis of combined chronic inflammatory demyelinating polyneuropathy (CIDP) in a patient with a cervical spinal cord lesion. At 3.5 months after the onset of symptoms, a 60-year-old female with mild motor weakness and significant weight loss underwent a surgical operation for decompression of the cervical spinal cord. However, her motor weakness was severely aggravated despite the surgical treatment, and she could not walk independently at 10 months after symptom onset. Based on the results of electrophysiological and cerebrospinal fluid tests, we diagnosed her with CIDP. Considering her medical history and the results of our evaluations, we think our patient’s neurological symptoms before the surgical operation were attributed, at least in part, to CIDP. Our study shows that clinicians should consider the possibilities of other lesions in different areas even when patients have a definite lesion in the cervical spinal cord or cervical spine.

Sudden hearing loss as an early detector of multiple sclerosis: a systematic review.

To evaluate whether Sudden Sensorineural Hearing Loss (S-SNHL) may be an early symptom of Multiple Sclerosis (MS). A systematic review was conducted using the following keywords: "Multiple sclerosis, hearing loss, sudden hearing loss, vertigo, tinnitus, magnetic resonance imaging, otoacoustic emission, auditory brainstem responses, white matter lesions, sensorineural hearing loss, symptoms of MS and otolaryngology, nerve disease and MS". Only the articles that included results of at least one auditory test and MRI were considered. We evaluated the prevalence of SNHL in patients with MS, the presence of different forms of SNHL (S-SNHL and Progressive SNHL (P-SNHL)) and their correlation with the stage of MS, the results of electrophysiological tests, and the location (if any) of MS lesions as detected by white matter hyperintensities in the MRI. We reviewed a total of 47 articles, which included 29 case reports, 6 prospective studies, 6 cohort studies, 4 case-control studies, and 2 retrospective studies. 25% of patients suffered from SNHL. S-SNHL typically occurred in the early stage of the disease (92% of patients) and was the only presenting symptom in 43% of female subjects. Instead, P-SNHL occurred in the late stage of MS (88% of patients). Auditory Brainstem Responses (ABR) were abnormal in all MS patients with S-SNHL. When S-SNHL appeared during the early stage of the disease, MS lesions were found in the brain in 60% of patients and in the Internal Auditory Canal in 40% of patients. ABR remained abnormal after recovery. S-SNHL can be an early manifestation of MS and should always be considered in the differential diagnosis of this condition, especially in women. The pathophysiology can be explained by the involvement of microglia attacking the central and/or peripheral auditory pathways as indicated by WMHs.

Utility of ultrasound elastography in a cohort of patients with idiopathic carpal tunnel syndrome

ObjectiveThe aim of this study was to assess the accuracy of ultrasound elastography as a recent imaging technique in diagnosis of CTS and evaluation of its severity in patients suffering clinically compared to the results of the gold standard electrophysiological tests. Materials and methodsThis was a prospective cross sectional study included 100 patients clinically diagnosed as having unilateral idiopathic CTS (90% of the dominant hand), referred to radiology department from physical medicine department at Alexandria main university hospital from June 2015 till May 2016 after being evaluated electrophysiologically for correlation with the data of the ultrasound and ultrasound elastography of the median nerve. A control group of 100 patients with no wrist or hand complain were included in the study. ResultsAs diagnosed electrophysiologically, there were 44 (44%), 35 (35%) and 21 (21%) patients with mild, moderate and severe degree of CTS respectively. The mean cross sectional area of the median nerve among the studied cases was 12.19 ± 1.59 mm2 while the mean strain ratio of the median nerve by ultrasound elastography was 2.20 (1.0–5.0). ConclusionIn addition to electrophysiological study, ultrasound and ultrasound elastography are valuable tools for the diagnosis and classification of CTS.

Chronic cuffing of cervical vagus nerve inhibits efferent fiber integrity in rat model

Objective. Numerous studies of vagal nerve stimulation (VNS) have been published showing it to be a potential treatment for chronic inflammation and other related diseases and disorders. Studies in recent years have shown that electrical stimulation of the vagal efferent fibers can artificially modulate cytokine levels and reduce systematic inflammation. Most VNS research in the treatment of inflammation have been acute studies on rodent subjects. Our study tested VNS on freely moving animals by stimulating and recording from the cervical vagus with nerve cuff electrodes over an extended period of time. Approach. We used methods of electrical stimulation, retrograde tracing (using Fluorogold) and post necropsy histological analysis of nerve tissue, flow cytometry to measure plasma cytokine levels, and MRI scanning of gastric emptying. This novel combination of methods allowed examination of physiological aspects of VNS previously unexplored. Main results. Through our study of 53 rat subjects, we found that chronically cuffing the left cervical vagus nerve suppressed efferent Fluorogold transport in 43 of 44 animals (36 showed complete suppression). Measured cytokine levels and gastric emptying rates concurrently showed nominal differences between chronically cuffed rats and those tested with similar acute methods. Meanwhile, results of electrophysiological and histological tests of the cuffed nerves revealed them to be otherwise healthy, consistent with previous literature. Significance. We hypothesize that due to these unforeseen and unexplored physiological consequences of the chronically cuffed vagus nerve in a rat, that inflammatory modulation and other vagal effects by VNS may become unreliable in chronic studies. Given our findings, we submit that it would benefit the VNS community to re-examine methods used in previous literature to verify the efficacy of the rat model for chronic VNS studies.