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Muscle excitability testing: Age and sex dependency of normative data 肌肉兴奋性测试:规范数据的年龄和性别依赖性
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-03-14 DOI: 10.1016/j.cnp.2025.03.002
Matthias Thomas Exl , Belén Rodriguez , Karl Ng , Stella Veronica Tan , James Howells , Hugh Bostock , Hatice Tankisi , Werner J. Z’Graggen

Objective

To establish normative data for muscle excitability testing in the tibialis anterior muscle of a healthy population, and to determine their dependence on age and sex.

Methods

Parameters of muscle velocity recovery cycle recordings with 1, 2 and 5 conditioning stimuli of 197 healthy subjects and frequency ramp recordings of 151 healthy subjects were retrospectively analysed for age and sex differences.

Results

There were no differences by sex and only small age differences were found in healthy subjects older than 60 years for the muscle excitability parameters muscle relative refractory period, early supernormality and latency to the first response in a train at 15 Hz and 30 Hz.

Conclusions

In this study, based on a large sample of muscle velocity recovery cycle and frequency ramp recordings, we have provided normative data and shown that muscle excitability testing is not influenced by sex, and that age only has an influence from the age of 60 years onwards on parameters reflecting muscle membrane potential.

Significance

Our results suggest that future studies no longer need to control for sex when using a healthy control group.
目的建立健康人群胫骨前肌兴奋性测试的规范性数据,并确定其对年龄和性别的依赖性。方法回顾性分析197名健康受试者在1、2、5条件刺激下的肌肉速度恢复周期记录参数和151名健康受试者的频率斜坡记录参数的年龄和性别差异。结果60岁以上健康受试者在15 Hz和30 Hz训练中肌肉兴奋性参数、肌肉相对不应期、早期异常和第一反应潜伏期均无性别差异,年龄差异较小。结论在本研究中,基于大量肌肉速度恢复周期和频率斜坡记录样本,我们提供了规范的数据,并表明肌肉兴奋性测试不受性别的影响,年龄仅在60岁以后对反映肌肉膜电位的参数有影响。意义:我们的研究结果表明,当使用健康对照组时,未来的研究不再需要对性行为进行控制。
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引用次数: 0
Multimodal tele-epileptology: Challenges on the way to interoperable medical data 多模式远程癫痫学:实现医疗数据互操作的挑战
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-02-28 DOI: 10.1016/j.cnp.2025.02.004
Sigrid Mues , Arndt Ebert , Marc Kämmerer , Marcus Kremers , Ulrich Sliwka , Rüdiger Hilker-Roggendorf , Dirk Woitalla , Iris Adelt , Thomas Günnewig , Ana Miron , Sulev Haldre , Tipakorn Tumnark , Kanjana Unnwongse , Wenke Grönheit , Tim Wehner , Vanessa Behrens , Jörg Wellmer

Objective

To realize multi-modal data exchange for telemedicine in epilepsy.

Methods

TE Ruhr is a multicenter, prospective pilot study. Primary endpoint of the study was the technical implementation of a platform between an epilepsy center and regional neurological departments and international cooperating epilepsy centers, respectively. A multi-professional board was established to develop technical workflows. After completion of the study a survey was conducted among users of the regional arm.

Results

Two workflows were developed, 1) a combination of web-application and use of an established teleradiology network, and 2) a web-application only data exchange. Technical workflow 1 comprised local EEG conversion into to a standard format (.besa) and its shipping as DICOM RAW object. Technically, both workflows could be implemented. Yet, workflow 1 was not realisable in peripheral hospitals. Via workflow 2, 149 consults for 144 patients were completed. Users of the regional arm were satisfied (1.6 on a grading scale of 1–6 (1-very good, 6- very bad)).

Conclusion

Technical feasibility alone does not determine the actual use of telemedicine. Web applications enables multimodal data exchange, but usability is limited due to lack of interoperability.

Significance

Genuine interoperability of medical data remains the desired goal for multi modal data exchange.
目的实现癫痫远程医疗的多模式数据交换。方法ste Ruhr是一项多中心前瞻性先导研究。研究的主要终点是癫痫中心与区域神经内科以及国际合作癫痫中心之间平台的技术实施。成立了一个多专业委员会来制定技术工作流程。研究完成后,对区域部门的用户进行了一项调查。结果开发了两种工作流程,1)web应用程序与已建立的远程放射学网络的结合,2)仅web应用程序的数据交换。技术工作流程1包括将本地EEG转换为标准格式(.besa)并将其作为DICOM RAW对象发送。从技术上讲,这两个工作流都可以实现。而工作流程1在周边医院尚未实现。通过工作流程,144名患者完成了149次咨询。在1-6(1-非常好,6-非常差)的评分范围内,区域臂的使用者是满意的(1.6)。结论技术可行性不能单独决定远程医疗的实际应用。Web应用程序支持多模式数据交换,但由于缺乏互操作性,可用性受到限制。真正的医疗数据互操作性仍然是多模态数据交换的理想目标。
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引用次数: 0
Presence of interictal epileptiform EEG discharges implies increased risk of recurrence after the first unprovoked seizure: Report of the International League Against Epilepsy and International Federation of Clinical Neurophysiology 间歇期癫痫样脑电图放电的存在意味着首次非诱发性癫痫发作后复发的风险增加:国际抗癫痫联盟和国际临床神经生理学联合会的报告
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-08-28 DOI: 10.1016/j.cnp.2025.07.007
Betül Baykan , John Dunne , Samuel Wiebe , Louis Maillard , Sandor Beniczky , Michalis Koutroumanidis , Margitta Seeck

Objective

A joint International Federation of Clinical Neurophysiology — International League Against Epilepsy (IFCN-ILAE) Taskforce was created to explore the published evidence for initial EEGs in the evaluation of patients who experienced their first unprovoked seizure, and to determine the diagnostic value of EEG in supporting the diagnosis of epilepsy.

Methods

We conducted a systematic literature review, with two independent authors screening each study. We extracted seizure recurrence data among patients with EEG showing interictal epileptiform discharges (IEDs) versus those with normal or nonspecific-abnormal EEG results. Random-effects meta-analyses of seizure recurrence in relation to IEDs was conducted in the included studies, calculating odds ratios (OR) with confidence intervals (CI) and diagnostic accuracy.

Results

A total of 4847 patients from 22 studies with variable follow-up durations were analysed. The random-effects pooled binary estimate of seizure recurrence was 47 % (95 % CI 40 %–55 %). The overall proportion with seizure recurrence was higher in patients with IEDs (60 %; 95 % CI 53 %–68 %) compared to those without (40 %; 95 % CI 33 %–48 %, p < 0.001). Random-effects meta-analysis showed that the presence of IEDs was associated with seizure recurrence (OR: 2.32, 95 % CI 1.69–3.17, p < 0.001). Subgroup analyses of adults and children showed that this difference remained significant in both groups: OR in children of 3.24 (95 % CI 2.19–4.79) and in adults of 1.55 (95 % CI 1.08–2.21). In eight studies (n = 1209, 923 children) patients remained untreated before the second seizure; the pooled probability of seizure recurrence in those with IED in these studies was no different than in studies in which some patients were treated.

Significance

In conclusion, the presence of IEDs in EEG recordings obtained after the first unprovoked seizure can help clinicians to confirm the clinical diagnosis of epilepsy after a first unprovoked seizure, according to the revised ILAE definition. These results support the relevance of IED detection on EEG as a predictor of seizure recurrence after a first unprovoked seizure. However, its prognostic value is influenced by age and other clinical factors.
目的成立国际临床神经生理学联合会-国际抗癫痫联盟(IFCN-ILAE)联合工作组,探讨已发表的脑电图在评估首次非诱发性癫痫发作患者中的证据,并确定脑电图在支持癫痫诊断中的诊断价值。方法我们进行了系统的文献综述,由两位独立作者对每项研究进行筛选。我们提取了脑电图显示间期癫痫样放电(IEDs)的患者与脑电图结果正常或非特异性异常的患者之间的癫痫复发数据。在纳入的研究中进行癫痫发作复发与ied相关的随机效应荟萃分析,计算优势比(OR)、置信区间(CI)和诊断准确性。结果共分析了22项不同随访时间的4847例患者。随机效应汇总二值估计癫痫复发率为47% (95% CI为40% - 55%)。发作复发的总体比例在ied患者中(60%;95% CI 53% - 68%)高于无ied患者(40%;95% CI 33% - 48%, p < 0.001)。随机效应荟萃分析显示,ied的存在与癫痫发作复发相关(OR: 2.32, 95% CI 1.69-3.17, p < 0.001)。成人和儿童的亚组分析显示,两组的差异仍然显著:儿童OR为3.24 (95% CI 2.19-4.79),成人OR为1.55 (95% CI 1.08-2.21)。在8项研究中(n = 1209,923名儿童),患者在第二次发作前未接受治疗;在这些研究中,IED患者癫痫发作复发的总概率与一些患者接受治疗的研究没有什么不同。总之,根据修订后的ILAE定义,在首次非诱发性癫痫发作后获得的脑电图记录中存在ied可以帮助临床医生确认首次非诱发性癫痫发作后癫痫的临床诊断。这些结果支持EEG上IED检测作为第一次非诱发性癫痫发作后癫痫复发的预测因子的相关性。但其预后价值受年龄及其他临床因素的影响。
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引用次数: 0
Rapid recovery after four months of near-tetraplegia: A case report of pan-neurofascin nodopathy and a brief review of emerging questions 近四肢瘫痪4个月后快速恢复:一例泛神经束蛋白病理报告和对新出现问题的简要回顾
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-09-28 DOI: 10.1016/j.cnp.2025.09.005
Dániel Milanovich, Zsolt Mezei, Anna Katalin Iljicsov, János Bíró, Zsuzsanna Arányi, Magdolna Simó

Objective

Pan-neurofascin nodopathy is a rare form of dysimmune neuropathies, mediated by antibodies against the common epitope of the 140, 155 and 186 neurofascin isoforms. These autoantibodies cause the defect of saltatory action potential spreading, disorganization of the nodal-paranodal ultrastructure, and axonal loss of variable degree.

Methods

A 32-year old male presented with the typical symptom of acute onset severe tetraparesis. Electrophysiological findings indicated severe conduction failure, but no appreciable axonal loss. High-resolution ultrasound showed diffuse, but patchy pathology, including mild enlargement and abnormal fascicular structure in proximal arm nerves and the brachial plexus. Symptoms worsened despite plasma exchange, and showed only mild and transient improvement upon repeated intravenous immunoglobulin treatment.

Results

After the verification of pan-neurofascin antibodies, rituximab treatment was applied and we observed rapid improvement within weeks, leading to complete remission at 6 weeks.

Conclusions

A young male with pan-neurofascin nodopathy presenting as acute-onset symptoms resembling Guillain–Barré syndrome, became asymptomatic following 4 months of near-tetraplegia as a result of rituximab therapy.

Significance

In pan-neurofascin nodopathy, rituximab treatment can lead to complete reversal of symptoms, even in cases characterized by prolonged and severe clinical manifestations. We also provide one of the first ultrasound descriptions of a pan-neurofascin case.
目的泛神经束蛋白结节病是一种罕见的免疫功能障碍神经病,由针对140,155和186神经束蛋白亚型共同表位的抗体介导。这些自身抗体导致跳跃式动作电位扩散缺陷,淋巴结-副淋巴结超微结构紊乱,以及不同程度的轴突损失。方法1例32岁男性,表现为急性发作型重度四肢麻痹的典型症状。电生理结果显示严重的传导障碍,但未见明显的轴突损失。高分辨率超声显示弥漫性,但斑片状病理,包括手臂近端神经和臂丛的轻度扩大和异常束状结构。血浆置换后症状恶化,反复静脉注射免疫球蛋白治疗后仅出现轻微和短暂的改善。结果在验证泛神经束蛋白抗体后,应用利妥昔单抗治疗,我们在几周内观察到快速改善,6周时完全缓解。结论1例年轻男性泛神经束蛋白结节病表现为类似格林-巴利综合征的急性发作症状,在接受利妥昔单抗治疗4个月后几乎四肢瘫痪,无症状。在泛神经束蛋白结节病中,利妥昔单抗治疗可导致症状完全逆转,即使在以长期和严重临床表现为特征的病例中也是如此。我们也提供了一个泛神经束蛋白病例的第一个超声描述。
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引用次数: 0
Intraoperative neurophysiology monitoring in posterior spinal fusion: insight from a Ghanaian patient with Brown-Séquard Syndrome 后路脊柱融合术中神经生理监测:来自加纳布朗- ssamquard综合征患者的见解
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-11-19 DOI: 10.1016/j.cnp.2025.11.002
Bright Worlanyo Aklamanu, Clement Okyere Sefa, Ebenezer Kodji Tetteh, Kwadzo Poku Yankey
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引用次数: 0
Impact of clinical neurophysiological assessment on diagnosis and management of tremor disorders 临床神经生理学评估对震颤障碍诊断和治疗的影响
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-06-12 DOI: 10.1016/j.cnp.2025.05.003
Katherine Longardner , Yasoda Satpathy , Irene Litvan , Dietrich Haubenberger

Objective

To assess the clinical utility of a standardized, non-invasive electrodiagnostic testing protocol in refining the diagnosis and management of patients referred for tremor evaluation.

Methods

In this prospective observational study, patients with tremulous limb movements with indeterminate clinical diagnoses involving tremor as a cardinal symptom were referred by movement disorders neurologists. Participants underwent standardized phenotyping and electrodiagnostic studies for tremor analysis including four-channel surface electromyography polygraphy and two-channel accelerometry.

Results

Clinical and electrophysiological data from 31 consecutive individuals were analyzed. Electrodiagnostic testing refined the differential diagnosis in 25/31 (80.6 %) participants and changed therapy in 14/29 (48.3 %). Changes included adjusting pharmacotherapy (n = 10), undergoing deep brain stimulation surgery (n = 2), or avoiding invasive procedures (n = 2).

Conclusions

We propose that electrodiagnostic testing is a clinically valuable tool that can narrow the differential diagnosis and impact treatment of tremor.

Significance

Clinical evaluation alone may be insensitive in diagnosing the tremor type when findings are subtle or when multiple movement disorders coexist. This may lead to inaccurate diagnosis and management, increasing cost and patient burden, and prolonging or preventing a successful journey towards adequate treatment. Clinical neurophysiology is a useful diagnostic procedure that can detect and quantify movements that may be otherwise indistinguishable by visual observation.
目的探讨一种标准化的、无创的电诊断测试方案在改进震颤评估患者诊断和管理中的临床应用价值。方法在这项前瞻性观察研究中,以震颤为主要症状的不确定临床诊断的震颤性肢体运动患者由运动障碍神经科医生转诊。参与者进行了标准化的表型和电诊断研究,以进行震颤分析,包括四通道表面肌电图和双通道加速度测量。结果对31例患者的临床和电生理资料进行分析。电诊断试验改善了25/31(80.6%)参与者的鉴别诊断,改变了14/29(48.3%)参与者的治疗方法。改变包括调整药物治疗(n = 10),接受深部脑刺激手术(n = 2),或避免侵入性手术(n = 2)。结论电诊断是一种有临床价值的工具,可以缩小震颤的鉴别诊断范围和影响治疗。意义当症状不明显或多种运动障碍共存时,单纯的临床评估可能对诊断震颤类型不敏感。这可能导致不准确的诊断和管理,增加费用和患者负担,并延长或阻止获得适当治疗的成功旅程。临床神经生理学是一种有用的诊断方法,可以检测和量化视觉观察无法区分的运动。
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引用次数: 0
Neurophysiology and muscle histopathology in ICU-acquired muscle weakness: Lessons learned from COVID-19 重症监护下获得性肌肉无力的神经生理学和肌肉组织病理学:从COVID-19中吸取的教训
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-05-07 DOI: 10.1016/j.cnp.2025.05.001
Eva K. Hejbøl , Atle V. Lomstein , Henrik D. Schrøder , Benjamin Khan , Thomas Harbo , Hatice Tankisi

Objective

To describe different electrophysiological, histopathological, and ultrastructural patterns of muscle pathology in COVID-19-associated intensive care unit acquired weakness (ICUAW) and raise the question of whether COVID-19-associated critical illness myopathy (CIM) is a distinct entity or is similar to CIM of other causes.

Methods

A series of three patients with COVID-19-associated ICUAW were presented.
Clinical examination, electrophysiological testing, and muscle pathology with light and electron microscopy were reported systematically.

Results

All three patients were clinically affected with severe proximal and distal weakness of upper and lower extremities, increased plasma levels of muscle enzymes, and had myopathic electromyography. Furthermore, in two patients, electrophysiological signs of inflammatory myopathy with profuse denervation activity were present. Muscle pathologies were prominent but very diverse. One patient had signs of CIM, another showed severe inflammatory myopathy, and the main finding in the third patient was mitochondrial changes.

Conclusion

Although the three cases showed similar clinical and electrophysiological patterns, muscle pathology revealed distinct underlying features. This spectrum of muscle disease among patients with severe COVID-19 includes CIM, autoimmune response to the COVID-19 infection, and mitochondrial dysfunction.

Significance

Electrophysiology and histopathology complement each other and are important for determining the etiology, as well as guiding treatment and prognosis.
目的描述新冠肺炎相关重症监护室获得性虚弱(ICUAW)患者肌肉病理的不同电生理、组织病理学和超微结构模式,并提出新冠肺炎相关危重病肌病(CIM)是一种不同的实体还是与其他原因的CIM相似的问题。方法对3例新型冠状病毒感染症(covid -19)相关ICUAW患者进行分析。系统地报道了临床检查、电生理检查和肌肉病理光镜和电镜。结果3例患者临床均表现为严重的上肢和下肢近端和远端无力,血浆肌酶水平升高,肌电图病变。此外,在两名患者中,存在炎症性肌病的电生理体征,伴有大量的去神经活动。肌肉病变很突出但也很多样。一名患者有CIM的迹象,另一名患者表现出严重的炎症性肌病,第三名患者的主要发现是线粒体改变。结论虽然3例患者表现出相似的临床和电生理模式,但肌肉病理表现出不同的潜在特征。严重COVID-19患者的肌肉疾病谱系包括CIM、对COVID-19感染的自身免疫反应和线粒体功能障碍。意义电生理与组织病理学相辅相成,对确定病因、指导治疗和预后具有重要意义。
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引用次数: 0
Comparison between sleep-deprived, and melatonin-induced sleep electroencephalography in children of different ages: a randomized controlled trial 不同年龄儿童睡眠剥夺和褪黑素诱发睡眠脑电图的比较:一项随机对照试验
IF 2 Q3 NEUROSCIENCES Pub Date : 2025-01-01 Epub Date: 2025-09-18 DOI: 10.1016/j.cnp.2025.09.002
Greta Gustafsson , Martin Ulander , Cornelia Lauermann , Johanna Thegerström , Kathe Dahlbom , Anders Broström , Eva Svanborg , Magnus Vrethem

Objective

To evaluate possible age-specific differences in the diagnostic yield of sleep-deprived, and melatonin-induced pediatric sleep EEGs. The multicenter study was performed prospectively.

Methods

Children referred to sleep EEG (n = 169), were stratified into three age groups (2–5; 6–11; 12–17 years) and randomized to sleep induction by melatonin or partial sleep deprivation. Epileptiform activity, sleep, adverse effects, and technical recording quality were compared between study arms and age categories.

Results

Epileptiform activity occurred in 36% of the children, without significant differences between melatonin and sleep-deprived EEGs. In 6–11-year-old children, epileptiform abnormalities occurred in 49%, significantly higher than in the other age groups independent of the sleep-inducing method. Sleep, but not the sleep induction method, was significantly associated with the presence of epileptiform activity (OR 9.16). The occurrence of sleep was significantly higher (97%) after melatonin induction compared to sleep deprivation (86%) without age differences. No serious adverse effects were registered.

Conclusions

There were no differences concerning the occurrence of epileptiform activity in EEG after melatonin induction or sleep deprivation in children of any age category. Melatonin increased the likelihood of sleep.

Significance

Melatonin as a premedication for sleep EEG should be considered safe and efficient in terms of diagnostic yield.
目的评价睡眠剥夺和褪黑激素诱发的儿童睡眠脑电图的诊断率可能存在的年龄特异性差异。多中心研究是前瞻性的。方法169例睡眠脑电图患儿按年龄分为2 ~ 5岁、6 ~ 11岁、12 ~ 17岁3组,随机分为褪黑素诱导组和部分剥夺睡眠组。癫痫样活动、睡眠、不良反应和技术记录质量在研究组和年龄组之间进行比较。结果36%的儿童出现癫痫样活动,褪黑激素与睡眠剥夺的脑电图无显著差异。在6 - 11岁儿童中,癫痫样异常发生率为49%,显著高于独立于睡眠诱导方法的其他年龄组。睡眠,而不是睡眠诱导法,与癫痫样活动的存在显著相关(OR 9.16)。褪黑激素诱导后的睡眠发生率(97%)明显高于睡眠剥夺(86%),没有年龄差异。未发现严重的不良反应。结论不同年龄组儿童在褪黑素诱导和睡眠剥夺后脑电图癫痫样活动的发生无明显差异。褪黑素增加了睡眠的可能性。就诊断率而言,褪黑素作为睡眠脑电图的前用药应被认为是安全有效的。
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引用次数: 0
Clinical neurophysiology of REM parasomnias: Diagnostic aspects and insights into pathophysiology 快速动眼期寄生虫的临床神经生理学:诊断方面和病理生理学见解
IF 1.7 Q3 NEUROSCIENCES Pub Date : 2024-01-01 Epub Date: 2024-01-10 DOI: 10.1016/j.cnp.2023.10.003
Melanie Bergmann , Birgit Högl , Ambra Stefani

Parasomnias are due to a transient unstable state dissociation during entry into sleep, within sleep, or during arousal from sleep, and manifest with abnormal sleep related behaviors, perceptions, emotions, dreams, and autonomic nervous system activity.

Rapid eye movement (REM) parasomnias include REM sleep behavior disorder (RBD), isolated recurrent sleep paralysis and nightmare disorder. Neurophysiology is key for diagnosing these disorders and provides insights into their pathophysiology.

RBD is very well characterized from a neurophysiological point of view, also thank to the fact that polysomnography is needed for the diagnosis. Diagnostic criteria are provided by the American Academy of Sleep Medicine and video-polysomnography guidelines for the diagnosis by the International REM Sleep Behavior Disorder Study Group. Differences between the two sets of criteria are presented and discussed. Availability of polysomnography in RBD provides data on sleep electroencephalography (EEG), electrooculography (EOG) and electromyography (EMG). Sleep EEG in RBD shows e.g. changes in delta and theta power, in sleep spindles and K complexes. EMG during REM sleep is essential for RBD diagnosis and is an important neurodegeneration biomarker. RBD patients present alterations also in wake EEG, autonomic function, evoked potentials, and transcranial magnetic stimulation.

Clinical neurophysiological data on recurrent isolated sleep paralysis and nightmare disorder are scant. The few available data provide insights into the pathophysiology of these disorders, demonstrating a state dissociation in recurrent isolated sleep paralysis and suggesting alterations in sleep macro- and microstructure as well as autonomic changes in nightmare disorder.

快速眼动(REM)寄生虫病包括快速眼动睡眠行为障碍(RBD)、孤立的复发性睡眠瘫痪和噩梦障碍。从神经生理学的角度来看,快速眼动睡眠障碍的特征非常明显,这也得益于诊断时需要进行多导睡眠图检查。诊断标准由美国睡眠医学学会制定,视频多导睡眠图诊断指南由国际快速眼动睡眠行为障碍研究小组制定。本文介绍并讨论了这两套标准之间的差异。RBD中的多导睡眠图可提供睡眠脑电图(EEG)、脑电图(EOG)和肌电图(EMG)数据。RBD 患者的睡眠脑电图可显示出 delta 和 theta 功率、睡眠纺锤体和 K 复合体等的变化。快速眼动睡眠时的肌电图是诊断 RBD 的重要依据,也是重要的神经变性生物标志物。RBD 患者在清醒时的脑电图、自主神经功能、诱发电位和经颅磁刺激也会发生改变。现有的少量数据为这些疾病的病理生理学提供了深入的见解,显示复发性孤立性睡眠瘫痪的状态分离,并表明睡眠宏观和微观结构的改变以及梦魇症的自主神经变化。
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引用次数: 0
Sensory nerve conduction studies in infants, children and teenagers – An update 婴儿、儿童和青少年的感觉神经传导研究--最新进展
IF 1.7 Q3 NEUROSCIENCES Pub Date : 2024-01-01 Epub Date: 2024-01-08 DOI: 10.1016/j.cnp.2024.01.001
Tom Frenzel , Anne-Katrin Baum , Hardy Krause , Christoph Arens , Aiden Haghikia , Imke Galazky

Objective

Nerve conduction studies (NCS) in children remain technically challenging and depend on the cooperation of the child. Motor NCS are not compromised by analgosedation but data for sensory NCS are lacking. Here, we ask whether sensory NCS is influenced by analgosedation. We also compare the present data with NCS studies from the 1990s regarding anthropometric acceleration of the contemporary paediatric population.

Methods

Sensory NCS of the median nerve and sural nerve were performed in 182 healthy subjects aged 1 to 18 years during general anaesthesia and in 47 of them without analgosedation.

Results

Sensory NCS was not influenced by midazolam or propofol. The sensory nerve action potential (SNAP) amplitude and the nerve conduction velocity (NCV) of the sural nerve as well as the SNAP of the median nerve show no significant age dependence in age range 1–18 years. The sensory NCV of the median nerve increased age-dependent.

Conclusions

In clinical practice, analgosedation can be used for diagnostic NCS. Sensory NCS data show no relevant secular trend over the last 30 years. Differences due to technical inconsistency predominate.

Significance

Analgosedation can improve diagnostic quality of sensory NCS in children. Additionally, we provide sensory NCS values from a large pediatric cohort.

目标儿童神经传导研究(NCS)在技术上仍具有挑战性,并且依赖于儿童的合作。运动神经传导不受镇痛的影响,但感觉神经传导却缺乏相关数据。在此,我们想知道感觉神经NCS是否会受到镇痛的影响。方法对 182 名 1 至 18 岁的健康受试者在全身麻醉期间进行了正中神经和硬脊膜神经的感觉 NCS,其中 47 名受试者在未使用镇痛剂的情况下进行了 NCS。硬神经的感觉神经动作电位(SNAP)振幅和神经传导速度(NCV)以及正中神经的感觉神经动作电位(SNAP)在 1 至 18 岁年龄范围内没有明显的年龄依赖性。结论在临床实践中,镇痛可用于诊断性 NCS。结论在临床实践中,镇痛可用于诊断性 NCS。在过去 30 年中,感觉 NCS 数据未显示出相关的世俗趋势。意义镇痛可提高儿童感觉 NCS 的诊断质量。此外,我们还提供了一个大型儿科队列的感觉 NCS 值。
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Clinical Neurophysiology Practice
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