Background/aim: Although ulnar neuropathy at the elbow (UNE) is the second most common entrapment mononeuropathy, there are few reports on its neurophysiological classification. In this study, we tried to find out the role of needle electromyography (EMG) in the neurophysiological classification of UNE. Materials and methods: UNE patients who met the clinical and neurophysiological diagnostic criteria and healthy individuals were included in this study. Reference values of nerve conduction studies were obtained from healthy individuals. Needle EMG was performed to all UNE patients. According to the neurophysiological classification proposed by Padua, UNE patients were classified as mild, moderate, and severe. Results: Thirty-one controls and thirty-five UNE patients were included in the study. There was mild UNE in 23 patients, moderate UNE in 8, and severe UNE in 4. Abnormal needle EMG findings were present in all patients with moderate and severe UNE and in 12 patients with mild UNE. Conclusion: Abnormal needle EMG findings are seen in most of the UNE patients. Therefore, it is not practical to use needle EMG findings in the neurophysiological classification. Needle EMG abnormalities may also be present in patients with mild UNE due to axonal degeneration or motor conduction block.
This is an open access article distributed under the terms of the CreativeCommons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND 4.0) where it is permissible to download, share, remix, transform, and buildup the work provided it is properly cited. The work cannot be used commercially without permission from the journal. AbstractAim: Late neuromuscular deterioration may be seen in patients with a history of paralytic poliomyelitis. One of these problems is the development of a new weakness in clinically unaffected muscles. We aimed to determine needle electromyography (EMG) findings in these clinically unaffected limb muscles and to contribute to the physiotherapy strategies of poliomyelitis. Methods: Patients with sequelae of poliomyelitis were included in this retrospective cohort study. Needle EMG findings of the patients were reviewed. If there were neurogenic needle EMG findings in the limb or muscle with no weakness, this muscle or limb was considered to be a subclinically affected muscle or limb. Results: Eighteen patients were included in the study. Needle EMG findings of 190 muscles were analyzed. In the lower extremities, 18 (72%) of 25 clinically unaffected muscles had neurogenic needle EMG findings, and 14 (35%) of 40 upper extremity muscles had subclinical involvement. In the lower extremity muscles, this subclinical involvement was significantly higher than in the upper extremity muscles (P=0.004). In clinically unaffected upper and lower extremity muscles, the most prominent neurogenic needle EMG findings were in the deltoideus and vastus lateralis muscles, respectively (P=0.022 and P=0.028, respectively). Conclusion: Subclinical involvement was more prominent in the lower extremity than in the upper extremity in polio survivors with weakness of lower extremity. The most prominent subclinical muscle involvement in the lower and upper extremities was the vastus lateralis and deltoideus muscles, respectively. We think that physical therapy strategies considering these findings will be beneficial for polio survivors.
Aim: The study aimed to find out whether there is a relationship between the mononeuropathies of the median, ulnar, radial, peroneal, and sciatic nerves and body mass index (BMI). Material and Methods: Patients whose clinical and electrodiagnostic findings were compatible with carpal tunnel syndrome (CTS), ulnar neuropathy at the elbow (UNE), radial neuropathy at the spiral groove (RNS), peroneal neuropathy at the fibular head (PNFH), and sciatic injury due to intramuscular injection (SNIII) were included in this retrospective cohort study. In addition, controls whose clinical and electrodiagnostic features were not compatible with mononeuropathy were included in the study. The BMI values of all participants were analyzed. Results: One hundred thirty-one CTS patients, 53 UNE patients, 6 RNS patients, 25 PNFH patients, 72 SNIII patients, and 53 controls were included in the study. The BMI of CTS patients was higher than the BMI of controls (p<0.001), PNFH patients (p<0.001), and SNIII patients (p<0.001). The BMI of SNIII patients was lower than the BMI of controls (p<0.001), CTS patients (p<0.001), and UNE patients (p<0.001). The BMI of PNFH patients was lower than that of CTS patients (p<0.001) and UNE patients (p=0.004). No significant correlation was found between BMI values and electrodiagnostic classification of mononeuropathies in the groups. Conclusion: This study showed that high BMI is a risk factor for CTS and low BMI is a risk factor for SNIII. There may also be a relationship between BMI and PNFH, but this should be confirmed by further studies.
Introduction: Entrapment mononeuropathies can cause motor conduction block, positive sharp waves, and fibrillation potentials. Aim: The study aims to find whether there is a relationship between positive sharp waves/fibrillation potentials and conduction block observed in entrapment mononeuropathies. Materials and methods: Patients with ulnar neuropathy at the elbow, radial neuropathy at the spiral groove, and peroneal neuropathy at the fibular head were included in this retrospective study. Nerve conduction study and needle electromyography results of the patients were analysed. Results: The study included a total of patients with 67 ulnar neuropathy, 8 radial neuropathy, and 27 peroneal neuropathy. All radial and peroneal neuropathy patients and 30 ulnar neuropathy patients had positive sharp waves/fibrillation potentials in at least one muscle. Twenty-three ulnar neuropathy patients with these potentials, 6 radial neuropathy patients, and 18 peroneal neuropathy patients had conduction block (p < 0.001). The reduction of compound muscle action potential amplitude in percentage recorded from the abductor digiti quinti/first dorsal interosseous across the elbow segment in ulnar neuropathy patients with and without positive sharp waves/fibrillation potentials was 41.9 ± 35.9/46.6 ± 36.1% and 7.6 ± 16.5/10.4 ± 16.5%, respectively (p < 0.001/p < 0.001). The distal compound muscle action potential amplitudes of ulnar neuropathy patients with these potentials were lower than those of ulnar neuropathy patients without these potentials (p = 0.029 – abductor digiti quinti, p = 0.017 – first dorsal interosseous). No correlation was found between the severity of positive sharp waves/fibrillation potentials and muscle strength in patients with these potentials (p > 0.05). Conclusions: Positive sharp waves/fibrillation potentials and motor conduction block can be seen together in patients with entrapment mononeuropathies. We concluded that there may be no relationship between the severity of these potentials and muscle strength.
Background & Objective: Needle electromyography (EMG) abnormalities can be observed in clinically affected or unaffected muscles in polio survivors. The primary aim of this study is to evaluate the positive sharp waves (PSWs) and fibrillation potentials (FPs) that can be observed in polio survivors. In addition, the presence of post-polio syndrome and radiculopathy was investigated in patients with PSWs/FPs. Methods: Clinical features and needle EMG findings of polio survivors with sequelae who applied to our neurophysiology laboratory between August 2018 and January 2021 were analyzed retrospectively. Cervical and lumbosacral magnetic resonance imaging (MRI) of polio survivors with PSWs/FPs were included in the analyses. In addition, polio survivors were divided into groups with and without post-polio syndrome. Results: Fifty-one polio survivors (33 male, 18 female) were included in the study. The mean age of the patients was 49.5±7.5 years. There were 13 (25.5%) polio survivors with post-polio syndrome. Needle EMG findings of 590 muscles were analyzed. PSWs/ FPs were found in 11 medial gastrocnemius, four iliopsoas, four tibialis anterior, two vastus lateralis muscles, and one deltoid muscle. PSWs or FPs were present in 12 (23.5%) of patients. PSWs/FPs were present in three (23.1%) and nine (23.7%) polio survivors with and without post-polio syndrome, respectively (p>0.05). Of the 12 patients with PSWs/FPs, 11 had cervical and lumbosacral MRIs. In eight (72.7%) of these 11 patients with PSWs/FPs, the nerve segment of the muscle with PSWs/FPs and the segment of radiculopathy detected by MRI were compatible with each other. Conclusions: This study indicated that PSWs/FPs may be present in polio survivors. PSWs/FPs may be due to radiculopathy and/or late deterioration. It was concluded that PSWs/FPs are not a parameter that can be used to differentiate polio survivors with and without post-polio syndrome.
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