Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology
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By co-activating A partial partial differential- and C-fibre nociceptors, intense CO2 laser heat stimuli produce a dual sensation, composed of first and second pain, but induce only a single A partial partial differential-fibre related late laser evoked potential (LEP). However, when avoiding concomitant activation of A partial partial differential-fibres, C-fibre related ultra-late LEPs are recorded. This poorly understood phenomenon was re-investigated using a method which, unlike time-domain averaging, reveals electroencephalogram (EEG) changes whether or not phase-locked to stimulus onset. ⋯ A partial partial differential- and C-fibre related LEPs could be electrophysiological correlates of similar brain processes, which, when already engaged by A partial partial differential-fibres, cannot or do not need to be reactivated by the later arriving C-fibre afferent volley. A partial partial differential-fibre related ERD could reflect a transient change of state of brain structures generating these responses.
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We evaluated the reliability of laser-evoked potentials (LEPs) as a diagnostic tool in patients with post-herpetic neuralgia (PHN), i.e. a chronic painful condition that causes small-diameter fibre dysfunction. Furthermore, we sought information on pathophysiology of PHN pain. ⋯ Being sensitive and reliable in assessing sensory function also in proximal dermatomes, LEPs are a promising diagnostic tool in radiculopathies. Although PHN severely impairs small myelinated fibres, the lack of a significant correlation between LEP abnormalities and pain suggests that pain in PHN does not chiefly arise from a dysfunction of small-myelinated afferents.
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To investigate changes in cortical motor neuron excitability after peripheral nerve injury, evoked spinal cord potentials (ESCPs) following hemispheric transcranial magnetic stimulation (TMS) were recorded in awake patients with unilateral brachial plexus injury. ⋯ From a study of ESCPs following single TMS, no evidence was obtained that cortical motor neuron excitability changes in patients with traumatic unilateral brachial plexus injury at relatively early stages. We investigated the changes of cortical motor neuron excitability in patients with brachial plexus injury from the ESCPs following TMS. In single TMS, our data gave no evidence for cortical excitability changes at relatively early stages.