신경전도검사의 정상치에 관한 연구

한송이,김대성,박규현,Han, Song-Yee,Kim, Dae-Seong,Park, Kyu-Hyun 대한임상신경생리학회 1999 Annals of Clinical Neurophysiology Vol.1 No.2

Background and Aims : Nerve conduction study is invaluable in clinical neurology, especially for assessing peripheral neuropathies. Abnormal nerve conduction studies may result not only from peripheral nerve dysfunction itself, but also from other various mechanical, technical, and physiological factors such as age, sex, height and temperature. So we conducted this study to establish the our own normal values. Methods : In this study, from March. 1997 to July. 1998, 40 Korean adults among person came to Health Promotion Center over the age of 20 without any suspicion of neurological deficits were analysed to determine the effect of compound effects of several physiological factors. Results : The nerve conduction velocities of the upper extremity and proximal segments were faster than those of the lower extremity and distal segments. Physiological factors such as age, height and temperature affect the results of nerve conduction studies in multiple regression analysis. The sex difference is recognized over peroneal motor nerve. There are no sex differences in amplitude transformed into normal distribution. The significant physiological factor affecting the amplitude of nerve conduction is age, whereas height and temperature play no role. Conclusions : In multiple regression analysis, height is widespread variable for the nerve conduction velocities and temperature is important variable for lower extremities. The parametric statistical analysis cannot be applied to the amplitude of the compound muscle or nerve action potentials because of marked left shift in distribution. Sqareroot transformation of the CMAP and CNAP may be useful in normalizing the distribution. The most significant physiological factor affection the amplitude is age. Sex differences are not seen in nerve conduction study.

상지의 외상성 말초신경 손상의 수술치료 효과

임경진,서정환,고명환,박성희,이내호 대한근전도전기진단의학회 2010 대한근전도 전기진단의학회지 Vol.12 No.1

Objective: To evaluate the outcome and the related factors after repairing of peripheral nerve (median and ulnar nerve) injuries using electrodiagnostic study. Method: The study included 32 patients (median nerve injury: 20 patients, ulnar nerve injury: 12 patients). We retrospectively reviewed medical records of patients for injury type, age, sex and duration after injury. All patients were evaluated with electrodiagnostic study at early after repairing surgery(12-29days) and follow up(13.0-52.5 months). We got the value of amplitude, conduction velocity in motor and sensory conduction test. Results: On follow up studies in median nerve group, amplitudes were significantly increased on motor and sensory nerve conduction study. On follow up studies in ulnar nerve group, amplitudes and conduction velocities were not significantly increased. In total rupture group, there became more presence of evoked potentials in motor nerve conduction study compared with sensory nerve conduction study. Conclusion: After neurorraphy in patients with severe nerve injury of upper extremities, there were substantial recoveries of motor and sensory function in electrophysiologic and functional aspects, especially in median nerve. The recovery of nerve injury was not related to age, sex and duration after injury.

원위부 족척신경 전도검사

이종민,최종철 大韓再活醫學會 1999 Annals of Rehabilitation Medicine Vol.23 No.1

흰쥐 대퇴신경의 복합신경전도검사

박기덕 梨花女子大學校 醫科大學 醫科學硏究所 1998 EMJ (Ewha medical journal) Vol.21 No.1

목적: 실험용 흰쥐에서 대퇴신경전도 검사를 정확히 시행할 수 있는 방법 개발 및 정상치 확인을 목적으로 하였다. 방법: 실험용 흰쥐의 뒷다리 피부를 절개하여 대퇴신경을 노출시킨 후 침전극을 사용하여 복합신경전도검사를 시행하였다. 결과: 1) 흰쥐에서 피부 절개를 통한 대퇴신경의 전기생리 검사인 복합신경전도검사는 비교적 간단하고, 일관된 검사결과를 얻을 수 있었다. 2) 신경전달속도의 평균은 35.45.6m/sec이었다. 3) 복합신경활동전위의 진폭은 개체간의 차이가 커서 본 실험방법에서는 신경의 전도 상태를 나타내는 정확한 인자로 사용하기에 어려움이 있을 것으로 판단된다. 결론: 본 신경전도검사 방법은 비교적 간단하면서도 신경전달속도 결과치가 정확하고 실험용 흰쥐에서 여러 차례 반복 시행할 수 있어서 말초신경병의 연구와 신경접합술 등의 술기와 관련된 실험 연구에서 그 결과를 확인할 수 있는 검사방법으로 사용될만한 것으로 판단된다. Objectives : To develop a proper electrophysiologic techniques for examining the rat femoral nerve. Methods : 10 Sprague Dawley rats were use to perform the electrophysiologic study of the exposed femoral nerves by surgical incision. Needle electrodes were used to stimulate the nerves and to obtain the compound nerve action potentials of those nerves. Results : The normal conduction velocity of femoral nerve in this method is 35.4±5.6m/sec and the mean amplitudes of compound nerve action potentials were 40.6±32.8μV. The data of conduction velocity was quite reliable with narrow ranges of standard deviations. But the compound nerve potentials amplitudes data showed wide ranges of variations among individual rats. Conclusion : The techniques and resultion data of femoral verve conduction of rats are described in this article. Even though this technique needs surgical incision exposing the noninvasiveness and rapid healing of the surgical wound in the rats. This verve conduction study method of examining femoral nerve in rats is relatively easy, accurate and repeatable techniques that permits visual and microscopic observation of the exposed nerves during the nerve conduction study.

상완신경총 손상의 상부 신경간 손상 환자의 감각신경전도검사

박효인,김지희,임진영,주민철 대한근전도전기진단의학회 2011 대한근전도 전기진단의학회지 Vol.13 No.1

Objectives: Localizing or evaluating lesions of upper trunk brachial plexopathy using conventional nerve conduction studies is not accurate. This study examined whether sensory nerve conduction studies are useful for detecting upper trunk brachial plexopathy. Methods: Sixty eight patients with upper trunk brachial plexopathy based on the intra-operative findings were selected among 162 cases of brachial plexopathy revealed by electrodiagnostic tests. All subjects were evaluated by extensive sensory nerve conduction studies including the lateral antebrachial cutaneous nerve, median nerve recorded at the 1st, 2nd and 3rd finger and superficial radial nerve, bilaterally. The following abnormalities were identified: lower amplitude or prolonged onset latency compared to the normal value or a decrease in amplitude more than 50% compared to the contralateral uninjured limb in the sensory nerve action potentials (SNAP). This study analyzed the percentage of abnormal latency and amplitude in the SNAP of lateral antebrachial cutaneous nerve, median nerve and superficial radial nerve. Results: The percentage of cases who showed abnormal findings of the nerve conduction studies in the lateral antebrachial cutaneous nerve, median nerve recorded from the 1st, 2nd and 3rd finger and superficial radial nerve group was 88.2%, 69.2%, 48.5%, 44.4% and 66.2%, respectively. Compared to the uninjured limb, the abnormal findings of nerve conduction studies in the lateral antebrachial cutaneous nerve, median nerve recorded from the 1st, 2nd and 3rd finger and superficial radial nerve group was 92.6%, 88.4%, 64.7%, 55.5% and 82.4%, respectively. Conclusion: Various nerve conduction studies, including the lateral antebrachial cutaneous nerve, median nerve recording at 1st digit and superficial radial nerve, are needed to diagnose upper trunk brachial plexopathy. Because most brachial plexopathy is axon loss, a comparison of the injured and uninjured limb is recommended even if the amplitude of SNAP is within normal limits.

내측고유족저족지 신경분지점의 해부학적 위치 분석

박근영,임선,김윤희,김영국 대한재활의학회 2009 Annals of Rehabilitation Medicine Vol.33 No.1

Objective: To analyze the bifurcating points of medial plantar proper digital (MPPD) nerve by using anatomical landmarks on plane coordinates and thus determine the ideal stimulation site for MPPD sensory nerve conduction studies. Method: We dissected 10 feet from five adult cadavers and identified the bifurcation points of the MPPD nerve. Two reference lines in relation to anatomical landmarks were defined. A vertical line connecting the mid-point of heel (H) and tip of great toe (G) was defined as the HG line. A transverse line connecting the navicular tuberosity (N) and tuberosity of 5th metatarsal bone (M) was defined as the NM line. The bifurcation points of the 10 MPPD nerves were expressed in X, Y coordinates in relation to these two axis. Results: The bifurcation points were located at approximately 40% (40.0±2.4; mean±SD) of the HG line from the mid-point of heel (H) and at approximately 37% (36.5±3.6) of the NM line from the navicular tuberosity (N). The majority of these points were found to be clustered close to the HG line. Conclusion: The data on the MPPD nerve bifurcation points may be useful to localize the appropriate stimulation site that could be used in MPPD nerve conduction studies. Objective: To analyze the bifurcating points of medial plantar proper digital (MPPD) nerve by using anatomical landmarks on plane coordinates and thus determine the ideal stimulation site for MPPD sensory nerve conduction studies. Method: We dissected 10 feet from five adult cadavers and identified the bifurcation points of the MPPD nerve. Two reference lines in relation to anatomical landmarks were defined. A vertical line connecting the mid-point of heel (H) and tip of great toe (G) was defined as the HG line. A transverse line connecting the navicular tuberosity (N) and tuberosity of 5th metatarsal bone (M) was defined as the NM line. The bifurcation points of the 10 MPPD nerves were expressed in X, Y coordinates in relation to these two axis. Results: The bifurcation points were located at approximately 40% (40.0±2.4; mean±SD) of the HG line from the mid-point of heel (H) and at approximately 37% (36.5±3.6) of the NM line from the navicular tuberosity (N). The majority of these points were found to be clustered close to the HG line. Conclusion: The data on the MPPD nerve bifurcation points may be useful to localize the appropriate stimulation site that could be used in MPPD nerve conduction studies.

정중운동신경과 척골운동신경의 전기생리학적 연구

김종순,이현옥,안소윤,구봉오,남건우,김영직,김호봉,류재관,류재문 대한정형도수치료학회 2005 대한정형도수물리치료학회지 Vol.11 No.2

The determination of peripheral nerve conduction velocity is and important part to electrodiagnosis. Its value as neurophysiologic investigative procedure has been known for many years but normal value of median and ulnar motor nerve was poorly reported in Korea. To evaluate of median and ulnar motor nerve terminal latency, amplitude of CMAP(compound muscle action potential), conduction velocity and F-wave latency for obtain clinically useful reference value. 71 normal volunteers(age,19-65 years;142 hands) examined who has no history of peripheral neuropathy, diabetic mellitus, chronic renal failure, endocrine disorders, anti-cancer medicine, anti-tubercle medicine, alcoholism, trauma, radiculopathy. Nicolet Viking Ⅱ was use for detected terminal latency, amplitude of CMAP, conduction velocity and F-wave latency of median and ulnar motor nerve. Data analysis was performed using SPSS. Descriptive analysis was used for obtain mean and standard deviation, independent t-test was used to compare between Rt and Lt side also compare between different in genders. The results are summarized as follows: 1. Median motor nerve terminal latency was right 3.00ms, left 2.99ms and there was no significantly difference between right and left side and genders. 2. Median motor nerve amplitude of CMAP was right 17.26mV, left 17.50mV and there was no significantly differences between right and left side and genders. 3. Median motor nerve conduction velocity was right 57.89m/sec, left 58.03m/sec and there was no significantly difference between right and left side and genders. 4. Median motor nerve F-wave latency was right 25.74ms, left 25.59ms and there was significantly differences between genders. 5. Ulnar motor nerve terminal latency was right 2.38ms, left 2.45ms and there was significantly differences between right and left side. 6. Ulnar motor nerve amplitude of CMAP was right 15.99mV, left 16.02mV and there was no significantly differences between right and left side and genders. 7. Ulnar motor nerve conduction velocity was right 60.35m/sec, left 59.73/sec and there was no significantly differences between right and left side and genders. 8. Ulnar motor nerve F-wave latency was right 25.53ms, left 25.57ms and there was significantly differences between genders.

인체 근육유래줄기세포의 말초신경재생 유도 효과

고준성,이지영,이지열 대한비뇨의학회 2008 Investigative and Clinical Urology Vol.49 No.4

Purpose: In this study, we evaluated the extent of functional and histological axonal regeneration after resection of the sciatic nerve. The nerve was repaired with silicone tubes filled with human muscle derived stem cells(MDSCs) and neuronal progenitor cells(NPCs) in nude mice. Materials and Methods: The human muscle samples were obtained from the rectus abdominis muscle of 12 patients that underwent a laparotomy. The MDSCs were isolated using a modified preplate technique. Using the MDSCs, neurogenic differentiation was induced by dissociating neurospheres produced in a neurosphere culture medium containing neuronal induction agents. A part of the sciatic nerve, approximately 7 mm in length, was excised bilaterally, and a 9mm long silicone tube guide was placed at the resulting gap in 40 nude mice. The transplanted sites were divided randomly into three groups according to the type of grafting cells: silicone tube guides filled with PBS(P group, n=20), silicone tube guides filled with MDSCs(M group, n=40) and silicone tube guides filled with NPCs(N group, n=20). Histological observations and a nerve conduction study were performed 12 weeks after the graft. Results: The number and diameter of the myelinated axons were significantly increased in the M and N groups(p<0.001). In a nerve conduction study, the amplitude of the compound muscle action potential(CMAP) and motor latency of response were significantly higher and shorter in the M and N groups(p<0.001). Moreover, reaction with neuronal class Ⅲβ-tubulin(Tuj1, a neuronal marker) and antiglial fibrillary acidic protein(GFAP, a glial marker) was observed in the regenerated nerve that originated from the M and N groups. Conclusions: These results show that MDSCs can differentiate into NPCs and improve the peripheral nerve regeneration rate after transplantation into a nerve guide. (Korean J Urol 2008;49:350-359) Purpose: In this study, we evaluated the extent of functional and histological axonal regeneration after resection of the sciatic nerve. The nerve was repaired with silicone tubes filled with human muscle derived stem cells(MDSCs) and neuronal progenitor cells(NPCs) in nude mice. Materials and Methods: The human muscle samples were obtained from the rectus abdominis muscle of 12 patients that underwent a laparotomy. The MDSCs were isolated using a modified preplate technique. Using the MDSCs, neurogenic differentiation was induced by dissociating neurospheres produced in a neurosphere culture medium containing neuronal induction agents. A part of the sciatic nerve, approximately 7 mm in length, was excised bilaterally, and a 9mm long silicone tube guide was placed at the resulting gap in 40 nude mice. The transplanted sites were divided randomly into three groups according to the type of grafting cells: silicone tube guides filled with PBS(P group, n=20), silicone tube guides filled with MDSCs(M group, n=40) and silicone tube guides filled with NPCs(N group, n=20). Histological observations and a nerve conduction study were performed 12 weeks after the graft. Results: The number and diameter of the myelinated axons were significantly increased in the M and N groups(p<0.001). In a nerve conduction study, the amplitude of the compound muscle action potential(CMAP) and motor latency of response were significantly higher and shorter in the M and N groups(p<0.001). Moreover, reaction with neuronal class Ⅲβ-tubulin(Tuj1, a neuronal marker) and antiglial fibrillary acidic protein(GFAP, a glial marker) was observed in the regenerated nerve that originated from the M and N groups. Conclusions: These results show that MDSCs can differentiate into NPCs and improve the peripheral nerve regeneration rate after transplantation into a nerve guide. (Korean J Urol 2008;49:350-359)

탈수초성 말초신경병증의 진단 뫼 추적관찰에 있어서 신경전도검사 표준화의 유용성

이경열 대한신경과학회 1998 대한신경과학회지 Vol.16 No.4

아급성 연합성 변성의 선경전도 검사

권기한,선우일남,정근호 대한신경과학회 1999 대한신경과학회지 Vol.17 No.2