Clinical Neuroscience

[BASIC NEUROGRAPHY AND ITS DIAGNOSTIC IMPORTANCE]

KISS Gábor

DECEMBER 10, 2005

Clinical Neuroscience - 2005;58(11-12)

[Nerve conduction studies are fundamental elements of the neurophysiological investigation of neuromuscular diseases. They provide information on peripheral nerve function. Knowledge of the biological and technical basis of the method is essential for the clinician to understand the place of nerve conduction testing in the diagnostic process. A characteristic feature of the nerve fibers is their ability to conduct electrical potentials. This conductivity changes in pathologic circumstances; therefore, the patient's nerve conduction data may be important if a neuromuscular disorder is suspected. The electrical activity spreading along the nerve fibres can be detected with special techniques and instruments. To perform an examination, a stimulator, a high quality amplifier and a computer with various accessories are necessary. The examination is usually carried out by surface stimulation and recording electrodes and requires some cooperation. By supramaximal stimuli all nerve fibers in the peripheral nerve are activated, and their summated activity is recorded bipolarly. For technical reasons the procedures for the motor and the sensory nerve conduction measurements are somewhat different, but their principles are similar. A number of parameters, such as the latency, the amplitude, the area and the shape of the evoked potentials are analyzed. These parameters are influenced by many biological (age, gender, body height, etc.), physical (such as limb temperature) and technical factors. The results are compared with the reference data. Nerve conduction studies may help distinguish between normal and diseased nerve function. The latter has two main categories; axonal lesion and demyelinisation. Axonal lesion is characterized by relatively normal conduction velocity and lower than normal amplitude of the potentials. Demyelinisation is almost the opposite with long latencies, slow conduction velocity and relatively spared potential amplitudes. Nerve conduction studies help differentiate between these two forms. Abnormalities found by nerve conducion measurement may reflect the severity of the disease. Repeated studies are suitable for quantitative follow-up. The anatomical, physiological, pathophysiological and technical details are discussed below. The characteristic neurographic findings of various diseases are also summarized.]

COMMENTS

0 comments

Further articles in this publication

Clinical Neuroscience

[ELECTROMYOGRAPHY AT THE BEGINNING OF THE 21st CENTURY]

DIÓSZEGHY Péter

[This review article is concerned with the role of electromyography (EMG) in the clinical diagnostic work. After a summary on the developmental history of electromyography, the most important EMG methods are presented. The modern quantitative EMG methods are sensitive and accurate thus providing important information in the evaluation of various neurological diseases, particularly in the diagnosis of neuromuscular disorders. The EMG examinations are useful tool for the clinician only if the applied methods are carefully chosen and properly performed and the rules of interpretation are strictly followed.]

Clinical Neuroscience

[Martin Schuster: Kunstpsychologie: Kreaivität - Bildkommunikation - Schönheit]

RAJNA Péter

Clinical Neuroscience

[THE ROLE OF EVOKED POTENTIAL METHODS IN THE NEUROLOGICAL CLINICAL PRACTICE]

KUNDRA Olga

[The author provides an overview on the value of evoked potential (EP) methods (VEP, SEP, BAEP, MEP) in the diagnosis and follow-up of various neurological diseases (multiple sclerosis, cerebrovascular disorders, degenerative diseases, coma, epilepsy, migraine) by reviewing the literature supported by his own clinical experience. While in the past EP was mainly used for establishing the diagnosis, recently, with the expansion of neuroradiology, it has gained a wider use in the assessment of the severity and extent of the pathologic process and especially in longitudinal follow-up. Its role in the diagnostic phase has diminished. In patients with multiple sclerosis the abnormality of the evoked potentials correlate better with the clinical state than with the MRI results. The method is also suitable to monitor the response to therapy. The importance of the EP tests is illustrated by several case demonstrations.]

Clinical Neuroscience

[PSYCHOPHYSIOLOGICAL AND CLINICAL ASPECTS OF THE EEG SYNCHRONIZATION RELATED TO COGNITIVE PROCESSES]

MOLNÁR Márk, CSUHAJ Roland, CSIKÓS Dóra, HAMVAI Csaba, CZIGLER Balázs, BÁLINT Andrea, GAÁL Zsófia Anna

[The authors review the various forms of EEG-synchronization with special emphasis on the characteristics of the induced and enhanced rhythms. The suggested role of the various EEG frequency bands in the cognitive processes is demonstrated by examples from the literature. The relationship between linear and nonlinear electrophysiological complexity and EEG synchronization is analyzed, with a touch on the use of Omega-complexity and synchronization likelihood methods. In the present study the EEG recorded during adding and subtracting tasks was analyzed with the above methods. It was found that during the adding task the theta band increased in the frontal area, which may be related to activation of working memory processes. Mapping the scalp-distribution of synchronization likelihood also confirmed increased synchronization in the frontal area in addition to which increased values were found in the left temporo-parietal area. The analysis of linear and nonlinear EEG synchronization associated with cognitive processing is suitable to explore the task-related and region specific features of these events.]

Clinical Neuroscience

[TRANSCRANIAL MAGNETIC STIMULATION: PHYSIOLOGY AND APPLICATIONS]

ARÁNYI Zsuzsanna

[Transcranial magnetic stimulation (TMS) is a relatively new technique that allows painless activation of cortical motor neurons. In the clinical setting, TMS is primarily used for the investigation of the corticospinal tract in various neurological diseases, being especially useful in the detection of subclinical dysfunction. In addition to the motor cortex, TMS can be applied to examine other structures inaccessible to electrical stimulation, such as the canalicular portion of the facial nerve. In healthy individuals, TMS can be utilized to monitor excitability changes of the motor system in various situations and muscles, providing valuable information to the understanding of the physiology of motor control. Furthermore, TMS can be used to explore interhemispheric connections as well as intracortical inhibitory and excitatory processes both in health and disease. Finally, with the help of TMS cortical maps of the representation areas of muscles can be constructed, giving insight to both short and long-term cortical plasticity and to the reorganisation of the motor cortex following damage to the brain or acquisition of new motor skills]

All articles in the issue

Related contents

Journal of Nursing Theory and Practice

[Examination of the quality of life in case of patient with the Multiple Sclerosis]

SZABÓ Julianna

[Aim of the research: To assess the impact of Multiple Sclerosis on quality of life and to consider whether there is a significant difference in the understand of the disease and the subjective assessment of quality of life in those subjects living in rural eastern Hungary and those living in Budapest. Research and sampling methods: the following questionnaires were use in the study: - Standard Test Questionnaire (SF-36) Social Support Questionnaire, and the Short Marital Stress Scale (abbreviated). Socio-demographic and disease indices were also utilized. These questionnaires were distributed to patients who have a diagnosis of Multiple Sclerosis. The patients attended the Neuro-immunology outpatients departments in the Budapest University’s St.Imre Teaching Hospital Specialist Multiple Sclerosis Centre and Josa Andras Hospital in Nyíregyháza (N=100), between August 2013 and January 2014. Results: It was found that due to the limiting nature of the disease the patients reported a significant effect on their physical condition. They were able to care for themselves in every day activities, but reported a limitation in leisure - time activities. Families play a decisive role in social contact. These results were confirmed by the patients’ observations. Those patients, who have the support of their spouses, report an increase in their health and wellbeing. There was little evidence of animosity towards those without Multiple Sclerosis.Those in Budapest achieved higher values in most dimensions, except social function and vitality, compared with those living in the country. Conclusions: The Researcher observed that relief organisations for the assistance and support of those with Multiple Sclerosis did not seem to meet the needs of the patients. Multiple Sclerosis is a chronic disease affecting all dimensions of Quality of Life. Need to strengthen the positive indicators of Quality of Life in those who are living with the disease and support families caring for those affected and enabling the maintenance of proper social relations and of social usefulness. ]

Clinical Neuroscience

[CHRONIC INFLAMMATORY POLYNEUROPATHIES]

BENICZKY Sándor, VÉCSEI László

[There is an increasing number of peripheral nerve disorders with inflammatory and immune mechanisms involved. The precise diagnosis is of utmost importance, since these patients can be successfully treated. Unfortunately, there is no specific marker for any disease of this group. The diagnosis therefore relies on the appropriate consideration of the clinical, neurophysiological and laboratory data, which requires in-depth knowledge of these diseases. In this paper we review the diagnostic criteria and treatment strategies for the major types of chronic inflammatory polyneuropathies.]

Hypertension and nephrology

[About the care of patients with hyperuricaemia and gout]

[This consensus document is intended to provide guidance for the effective and efficient treatment of asymptomatic individuals with high uric acid levels and gout patients.]