Muscle & nerve
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The aims of this study were to identify factors affecting the measurement of nerve cross-sectional area (CSA) and to establish normal reference values for nerve ultrasonography of the upper extremity. ⋯ The normal reference values may be helpful in diagnosis of pathologies involving these nerves.
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Normative cross-sectional areas (CSAs) have been obtained for the Western population. We obtained CSAs of normal ulnar nerves at predetermined sites and correlate them with electrophysiological variables in Asian subjects. ⋯ Ulnar CSA correlated with age, gender, and distal motor latency. No correlations were observed with height, weight, or body mass index.
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Neuromuscular disorders, predominantly critical illness myopathy (CIM) and critical illness polyneuropathy (CIP) occur in approximately one-third of patients in intensive care units. The aim of this study was to review the important role of electrophysiology in this setting. ⋯ Knowledge of the various neuromuscular disorders in critically ill patients, their risk factors, and associated electrodiagnostic findings can lead to development of a rational approach to diagnosis of the cause of neuromuscular weakness in ICU patients.
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Neuromuscular clinicians are often asked to evaluate the diaphragm for diagnostic and prognostic purposes. Traditionally, this evaluation is accomplished through history, physical exam, fluoroscopic sniff test, nerve conduction studies, and electromyography (EMG). ⋯ Neuromuscular ultrasound has emerged as a non-invasive technique that can be used in the structural and functional assessment of the diaphragm. In this study we review different techniques for assessing the diaphragm using neuromuscular ultrasound and the application of these techniques to enhance diagnosis and prognosis by neuromuscular clinicians.
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Objective diagnosis of small fiber impairment is difficult. ⋯ Both axon-reflex tests are helpful to identify objectively patients with small fiber impairment. Afferent and efferent C-fiber classes can be impaired differently. These tests detect small fiber impairment, but they cannot differentiate between painful and nonpainful neuropathy.