Neurophysiologie clinique = Clinical neurophysiology
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Dysfunction of small fibers may appear in isolation or associated with large fiber lesions. In some acute neuropathies, such as pandysautonomia, small-fiber impairment is relatively pure but it may also appear in disorders with prominent somatic damage, such as Guillain-Barré syndrome, in which autonomic failure worsens the prognosis. At the present time, chronic idiopathic distal small-fiber neuropathy is diagnosed more frequently, and in some prevalent disorders, such as diabetic or amyloidotic polyneuropathies, small-fiber dysfunction is very noticeable. ⋯ In this review, we describe and analyze a number of neurophysiological techniques used to diagnose and characterize small-fiber dysfunction in humans. These include cardiovascular monitoring, sudomotor testing, pupillary responses and quantitative sensory tests, and also to some extent thermography and laser evoked potentials. The use of such techniques has proven useful not only for diagnosis, but also to guide adequate therapy and optimize follow-up.
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Eye movements cause changes to the electric fields around the eyes, and consequently over the scalp. As a result, EEG recordings are often significantly distorted, and their interpretation problematic. ⋯ Issues discussed include the distinction between frequency and time domain approaches, the number of EOG channels required for adequate correction, estimating correction coefficients from raw versus averaged data, differential correction of different types of eye movement, the most suitable statistical procedure for estimating correction coefficients, the use of calibration trials for the estimation of correction coefficients, and the distinction between 'coefficient estimation' and 'correction phase' error. A suggested EOG correction algorithm is also described.