Journal of clinical neuromuscular disease
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J Clin Neuromuscul Dis · Mar 2012
Outcome prediction value of nerve conduction studies for endoscopic carpal tunnel surgery.
Carpal tunnel syndrome is the most common entrapment neuropathy. We explore the clinical use of nerve conduction study in the outcome prediction and preoperative selection for endoscopic carpal tunnel syndrome surgery. ⋯ A shorter distal sensory latency is associated with a higher likelihood of a good outcome for paraesthesia. In addition, patients with baseline of 4 or above had correlated with better surgical outcome than those with less severe symptoms. Our data thus suggest that surgical benefit is best seen in patients with moderate symptoms, in combination with electrophysiological evidence of early demyelination, as a possible therapeutic window.
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J Clin Neuromuscul Dis · Sep 2011
Ocular myasthenia gravis in an academic neuro-ophthalmology clinic: clinical features and therapeutic response.
The frequency of ocular myasthenia gravis (OMG) in patients referred to an academic neuro-ophthalmology clinic for suspected myasthenia gravis is not known. Our objective was to determine the frequency of ocular OMG in patients referred to an academic neuro-ophthalmologist and determine alternate diagnoses and response to therapy. ⋯ The diagnosis of myasthenia gravis was confirmed in the majority of patients referred to our academic neuro-ophthalmology clinic, but 27% did not have myasthenia gravis. It is possible that prednisone treatment of OMG may prevent progression to TMG, but further study is required.
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J Clin Neuromuscul Dis · Jun 2011
Review Case ReportsNeuromuscular disorders in critically ill patients: review and update.
Neuromuscular disorders that are diagnosed in the intensive care unit (ICU) usually cause substantial limb weakness and contribute to ventilatory dysfunction. Although some lead to ICU admission, ICU-acquired disorders, mainly critical illness myopathy (CIM) and critical illness polyneuropathy (CIP), are more frequent and are associated with considerable morbidity. Approximately 25% to 45% of patients admitted to the ICU develop CIM, CIP, or both. ⋯ Outcomes are variable. They tend to be better with CIM, and some patients have longstanding disabilities. Future studies of well-characterized patients with CIP and CIM should refine our understanding of risk factors, outcomes, and pathogenic mechanisms, leading to better interventions.
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J Clin Neuromuscul Dis · Mar 2011
Review Case ReportsHyperalgesia after volar wrist tattoo: a case of complex regional pain syndrome?
Hyperalgesia after a volar wrist tattoo with features consistent with complex regional pain syndrome and a brief literature review is presented. This is the first case of disseminated hyperalgesia reported from a tattoo. ⋯ The response to prednisone was robust. Further cases may appear considering popularization of wrist tattoos by celebrities.
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J Clin Neuromuscul Dis · Mar 2011
Comparative StudyComparison of sudomotor and sensory nerve testing in painful sensory neuropathies.
To compare results of quantitative sudomotor axon reflex testing (QSART), dorsal sural, and sural sensory nerve testing in patients with painful sensory neuropathy (PSN). ⋯ This study demonstrates the value of combining both QSART and dorsal sural sensory testing in verifying the diagnosis of PSN. The majority of cases demonstrate involvement of unmyelinated C fibers as well as large/medium myelinated fibers, thereby separating mixed large- and small-fiber sensory neuropathies from those cases classified by clinical criteria solely as small-fiber neuropathy.