Background: Guillain-Barre syndrome (GBS) is the most common cause of acute motor paralysis in children where most of electrophysiological findings reveal demyelinating neuropathy. However, an axonal form of Guillain-Barre syndrome had been reported too. Objectives: Assess the role of neurophysiological study (EMG and NCS) in the diagnosis of Guillain-Barre syndrome subtypes in children and estimate the frequency of subtypes whether demyelinating or axonal form of Guillain-Barre syndrome. Subjects and methods: Two study groups of either sex was involved, thirty (30) Guillain-Barre patients with different ages and thirty(30) normal healthy subjects matched for age and gender served as control group. Each subject submitted to sensory and motor nerve conduction study (NCS) and electromyography (EMG) of both upper and lower limbs. Results:The results of this study revealed that 24 (80%), 5 (16.7%), 1 (3.3%) had Acute inflammatory demyelinating polyneuropathy, Acute motor axonal neuropathy and Acute motor sensory axonal neuropathy respectively. The most affected age group was (3-6) years, and the majority of patients had a preceding infection in the past 3 months. Furthermore, 29 patients out of 30 had lost deep tendon reflexes and the H-reflex was absent in 22 (73.3%), however, the F-wave was absent in lower limbs more than upper limbs (46.6%) and (26.6%) respectively. The distal motor latency was abnormal in 121 (82.3%) nerves out of 147 total examined nerves. Conclusion:Acute inflammatory demyelinating polyneuropathy (AIDP) is the most frequent subtype of GBS, the change in sensory and motor NCS parameters was higher in lower limbs than upper limbs. Proximal segments are more vulnerable to demyelination rather than intermediate or distal nerve segments.

No abstract

Background: Multiple sclerosis (MS) is a chronic, demyelinating disease of the central nervous system (CNS) affecting young adults and is considered as the leading cause of non traumatic neurological disability of young adults affecting nearly 2 million people worldwide. The pathogenesis of MS is at best incompletely understood. There are several proposed mechanisms that may be important in the production of MS plaques: autoimmunity, environment and heredity. Deviation of immune responses in a genetically susceptible patient plays a central role in its pathogenesis. Electrophysiological, spinal tap and Radiological tools are important laboratory investigations and have added so much to the clinical diagnosis and for the classification of MS. It was found that visual function and conduction has been changed in patients with multiple sclerosis. Objectives: The aims of the study is to estimate and evaluate the visual evoked potential (VEP) parameters in patients with MS and its relation to their disability degree (using the expanded disability status scale score "EDSS") and visual presentation of them in comparison with healthy individuals. Patients and Methods: 112 patients with multiple sclerosis and 50 subjects without any neurological or psychiatric diseases as control group were recruited in this study. The cases were collected from Baghdad teaching hospital, MS center, Baghdad, Iraq at the period from May 2012 to April 2013, and studied at the unit of electrophysiology in Al-Shaheed Ghazi Al-Hareri Hospital in the Medical city. All patients and control groups were tested for VEP. Results: The present study showed a significant increase in the P100 latency and inter-ocular (IO) latency difference and non statistical significant decrease in the IO amplitude difference in patients group than the control group. Also among patients group there was positive linear correlation between the severity of the disease measured by EDSS score and P100 latency while negative linear correlation with the amplitude. Conclusion: There was a higher percent of patients with defective VEP parameters and so their visual pathway even if it was asymptomatic, in addition to their relation with patients` disability than the control group, making it easy to quantify and predict MS disability objectively.

Background: Atrioventricular nodal reentrant tachycardia (AVNRT) is the commonest regular supraventricular tachyarrhythmia. Ablation in the area of slow pathway (SP) has been successfully implemented in every day clinical electrophysiological practice for more than 20 years. Although the procedure is generally regarded as effective and safe, data on long-term effects and predictors of success or failure are incomplete.Objectives: This study was designated to prove that AH interval is an electrophysiological parameter which serves as a predictor for successful AVNRT ablation.Methods: While performing an electrophysiological study using a programmed atrial stimulation, thirty nine (39) patients (25 female and 14 males) with a mean age 51 ± 16.7 years with AVNRT were assessed and underwent AVNRT radiofrequency ablation using diagnostic and ablation catheters inserted via the right femoral veins. This study was performed during the period from February, 2013 to march, 2014 at the unit of Electrophysiogy in Leipzig heart center.Results: Acute successful AVNRT ablation was achieved in 39 (100%) patients, including 23 (59%) with slow pathway (SP) ablation and 16 (41%) with SP modification. Patients with SP modification were younger male, had faster AVNRT cycle length, and had more frequent isoproterenol usage before ablation. During six months follow-up period, all patients experienced no AVNRT recurrences. .Conclusions: AH jump served as predictor for successful Ablation of atrioventricular nodal reentrant tachycardia with a better outcome.

Background: Endothelial dysfunction is thought to be a key event in the development of atherosclerosis. It is a systemic process that simultaneously affects different vascular territories including coronary arteries. It is recommended that noninvasive approaches assessing endothelial function in peripheral vessels like flow mediated dilatation are indirectly representative of coronary vascular function.Objectives: This study is aimed to assess endothelial dysfunction by using flow mediated dilatation in patients with coronary artery diseasePatients and methods: 82 patients of either sex with an age range of 40-65years are involved in this study. Each patient was subjected to two tests; first test was the flow mediated dilatation percentage (FMD%) measurement to assess endothelial functional integrity and second one was coronary computerized tomography angiography for measuring the percentage of coronary artery stenosis.Results: the results of this study revealed that FMD% is inversely correlated with the percentage of coronary artery stenosis (p value <0.01). FMD% in patients having a single coronary vessel atheromatous stenosis (9.9±3.5) % was significantly lower than that of control subjects (15.3±7) %, p<0.0001.Conclusion: this study concludes that FMD% of brachial artery could be used as a marker for systemic endothelial functional integrity including that of coronary arteries.