Our results suggest PNB is a relatively common etiology of sciatic neuropathy and is an important consideration in the differential diagnosis. These findings should urge electromyographers to assess history of PNB in sciatic neuropathies, particularly with onset after surgery. Muscle Nerve 56: 822-824, 2017.
Kneeling in a restricted posture during manual materials handling has been associated with increased risk of low back pain. Little is known about the effect of kneeling posture on spinal loads. The purpose of this study was to compare differences in spinal loading between kneeling and standing postures for lifting tasks. Twelve subjects asymmetrically lifted luggage of three weights to three heights from floor while kneeling. Three subjects also performed the same tasks from waist height while standing. An adapted free-dynamic EMG-assisted biomechanical model was used to calculate spinal loads. Statistical analysis showed that there was no difference in compression between kneeling and standing (p=0.9605), but kneeling resulted in increased anterior-posterior and lateral shear forces on the lumbar spine (p =0.0002 and p<0.0001, respectively). Spinal loading changes while kneeling in a restricted posture may increase the risk of low back injury and must be considered in ergonomic job design.
MFS has been reported to recur in 10-12% of patients. There may be a genetic component related to HLA-DR2. Anti-GAD antibodies can be present in MFS along with anti-GQ1b. Common EMG/NCS associations consist of a predominantly axonal, sensory polyneuropathy and absent H reflexes. A 32-year-old female with a history of hypothyroidism presented to our institution twice with symptoms of diplopia, lower extremity weakness and distal paresthesias occurring a year apart. She had ophthalmoplegia, reduced reflexes, and ataxia on exam. CSF showed a borderline elevated protein of 47 and white blood cells <3. She was positive for anti-GQ1b both times. Her anti-GAD65 antibody was elevated during both admissions. EMG/NCS on her first admission revealed comparatively reduced sensory nerve action potentials (SNAPs) and a normal blink reflex. Her SNAPs improved on the second admission, however, the EMG was performed only 2 days after the onset of her symptoms, limiting some early findings that may have not matured electrophysiologically. She was treated with IVIG on both occasions with rapid recovery within 5 days. This case highlights the fact that MFS can be recurrent. It also provides further evidence that anti-GAD antibodies may be associated with MFS. Reported findings of the blink reflex in MFS are diverse and further data is needed to determine if certain findings are more predominant than others. Treatment typically consists of IVIG, though steroids may also be considered for recurrence. Prognosis is generally favorable, regardless of treatment.
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