Lateral pectoral nerve conduction

The aim of this study was to measure the motor conduction time (MCT) and velocity of the lateral pectoral nerve (LPN) in normal subjects and patients with neuropathy. For the LPN, we determined that the average AICT was 3.9 m/s using Erb stimulation with needle recording, and the average motor conduction velocity was 70.6 m/s using Erb stimulation and axilla stimulation with needle recordings in normal subjects. In patients, prolonged MCT in LPN was found in 3 of 6 Patients with unilateral plexopathy and 3 of 4 patients with polyneuropathy. If was determined that MCT and motor conduction velocity in LPN was as sensitive as biceps brachii MCT in patients with unilateral plexopathy. Furthermore, the motor conduction velocity in the LPN may be beneficial to elucidate the localization of involvement in polyneuropathies, such as distal or proximo-distal

Ribot's law and leo tolstoy

[No Abstract Available

Neurogenic Dysphagia in Brainstem Disorders and EMG Evaluation

WOS: 000414778500002Neurogenic dysphagia is a prevalent condition that may result in serious complications. Screening and follow up are critical for early diagnosis, prognosis and management which can mitigate its complications and be cost-saving. Several Neurophysiological methods are described to evaluate the Neurogenic Dysphagia including Single Bolus Analysis, Dysphagia Limit, Cricopharyngeal sphinter electromyogram (EMG), Continuous water swallowing with respiratory recording, Polygraphic recording for spontaneous swallows in awake and sleeping states. All techniques mentioned above were developed in our laboratory. Brain stem disorders are particularly important to investigate the presence of dysphagia due to its high incidence and also its severity. These swallowing methods presented and discussed in this review are reliable, cheap and easy applicable quantitative tests to detect and to follow up both subclinical and clinical dysphagia

Voluntary Versus Spontaneous Swallowing in Man

WOS: 000290806600011PubMed ID: 21161279This review examines the evidence regarding the clinical and neurophysiological differences between voluntary and spontaneous swallows. From the clinical point of view, voluntary swallow (VS) occurs when a human has a desire to eat or drink during the awake and aware state. Spontaneous swallow (SS) is the result of accumulated saliva and/or food remnants in the mouth. It occurs without awareness while awake and also during sleep. VS is a part of eating behavior, while SS is a type of protective reflex action. In VS, there is harmonized and orderly activation of perioral, lingual, and submental striated muscles in the oral phase. In SS, the oral phase is bypassed in most cases, although there may be partial excitation. Following the oral phase, both VS and SS have a pharyngeal phase, which is a reflex phenomenon that protects the upper airway from any escape of food and direct the swallowed material into the esophagus. This reflexive phase of swallowing should not be confused with SS. VS and SS are similar regarding their dependence on the swallowing Central Pattern Generator (CPG) at the brainstem, which receives sensory feedback from the oropharynx. There are differences in the role of the corticobulbar input between VS and SS

Reflex influences on oropharyngeal swallowing

Swallowing is a complex sensorimotor behaviour involving the coordinated and reflex contraction and inhibition of the musculature located in and around the mouth, larynx, pharynx and esophagus. Voluntary swallowing is under the the control of thecerebral cortex and other subcortical structures, but the main locations are the nucleus tractus solitarius and nucleus ambiguus,and their neural network of central pattern generator. In spite of these central controls, there are some intrinsic reflex actionsbetween three phases of swallowing. These kind of reflexes were emphasized in this review.Swallowing is a complex sensorimotor behaviour involving the coordinated and reflex contraction and inhibition of the musculature located in and around the mouth, larynx, pharynx and esophagus. Voluntary swallowing is under the the control of thecerebral cortex and other subcortical structures, but the main locations are the nucleus tractus solitarius and nucleus ambiguus,and their neural network of central pattern generator. In spite of these central controls, there are some intrinsic reflex actionsbetween three phases of swallowing. These kind of reflexes were emphasized in this review

Lumbar Spinal Stenosis and Intermittent Neurogenic Claudication

Lumbar spinal stenosis and intermittent neurogenic claudication is a disease that occurs frequently after the age of 55 and becomes complicated after the age of 65 in clinical, radiological and therapeutic aspects. In this review, acquired spinal stenosis secondary to degenerative osteoarthritis is evaluated. In this disease, lumbar and extremity pain and paresthesia are frequent; however, the most characteristic feature of the disease is the occurrence and worsening of these findings with erect posture and walking (intermittent neurogenic claudication). Even though the radiological findings of spinal stenosis are apparent, 1/4-1/5 of the patients may be asymptomatic. In order to support the clinical findings, neurophysiological tests have been used at rest and motion. Certain electrophysiological signs have been found to change after motion. The most helpful signs are the denervation of paravertebral and leg muscles, H-reflex abnormalities, and the findings obtained with the recently used radicular excitation methods. Electrophysiological methods have been found to be more compatible with the clinical findings. Lumbar surgical approach is considered in patients with impaired life quality and in those unresponsive to conservative treatmen

Sequential water swallowing in normal adults and patients with neurogenic dysphagia

Sequential water swallowing (SWS) is usual ingestive behavior. SWS was used previously on the criteria just in the clinical bases of laryngeal penetration or incomplete drinking of the amount of 90-150 mL water. They did not use any kind of physiological monitoring. Invasive methods such as Videoflouroskopy could not be suitable for continuous deglutition in that time and the amount of fluids because of possible hazardous side effects. Last methods is a kind of discrete swallowing (5-15 mL). Thus we need SWS from a cup or straw. SWS is favorable method for longutidinal studies. SWS investigations from our and other laboratories are not commonly published compared to the other kind of tremendeous swallowing studies. There is a need for a comprehensive review about SWS with the physiological and the clinical results. Four chan-nel electromyography is necessary for submental muscle complex, nasal sensor for respiration, electrocardiogram and the electrodermal activity. A coordination in between swallowing and respiration was found significantly pathologic even in asymptomatic dysphagia in the chronic neurological disorders such as multiple sclerosis, Parkinson’s disease, Parkinson plus syndromes and brainstem infarctions. in amyotrophic lateral sclerosis there was an irregularity in swallowing behavior in almost half of the patients. Guillain Barre syndrome with cranial nerve involvement showed silent dysphagia. Alzheimer disease had a risk of dysphagia in early period and dysphagia was increased, progressively, until the late stage of disease. Therefore the SWS is easy to use, repeatable, safe and a cheap method and this field is especially important and suitable use of neurologist and electromyographer