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Biomedical subjects

B Bady

Publications and source records attributed to B Bady.

At least 37 records · Page 2Linked to original sources
PubMed1992

[Suprascapular nerve entrapment at the spinoglenoid notch].

The suprascapular nerve passes through the spinoglenoid notch with a risk of entrapment. This results in distal nerve lesion characterized by isolated paralysis of the infraspinatus muscle and, most often, by shoulder pain. We report 7 clinical and electromyographical cases of pure infraspinatus muscle paralysis. The value of the electrodiagnosis, which demonstrated prolonged suprascapular distal nerve latencies (over 5 milliseconds) in the infraspinatus muscle affected while latencies were normal in the supraspinatus muscle, is emphasized. Mechanical factors were associated with paralysis in 5 cases. Compressive synovial cysts were found in 2 patients operated upon. Surgical enlargement of the spinoglenoid notch regularly and rapidly relieves pain and sometimes helps in recovery of the infraspinatus muscle.

Adolescent↗
PubMed1992

[Lambert-Eaton syndrome: clinical and electrophysiological study of 18 cases associated with lung cancer].

The clinical and electrophysiological data of 18 consecutive adult patients with paraneoplastic Lambert-Eaton myasthenic syndrome (LMES) have been reviewed. The cancer associated with LEMS was small-cell lung carcinoma (SCLC) in 15 cases and epidermoid lung carcinoma in 3 cases. The main clinical neurological features were proximal lower limb weakness (100%), depressed tendon reflexes (94%) and dryness of the mouth (66%). The results of repetitive nerve stimulation (RNS) were not statistically different in the paraneoplastic LEMS group and in a group of 6 LMS patients in whom no carcinoma had been detected. Low-amplitude compound muscle action potential (CMAP) was present in all cases; decremental response at low stimulation rates was present in 13/15 cases. An abnormal incremental response at high stimulation rates was observed in all cases. A close correlation between CMAP amplitude and clinical condition was found in 4 cases during the long-term follow-up. In one patient the RNS electrical pattern could be misinterpreted as myasthenia gravis in only one muscle tested. We underline the usefulness of a 50 Hz stimulation during 4 seconds to establish the diagnosis unequivocally, and that of post-exercise facilitation in routine detection among an SCLC population. Our results suggest that CAMP amplitude and RNS test could be used to evaluate the short-term improvement of LMS under treatment and, in some cases, for the long-term follow-up. The infraclinical axonal neuropathy detected in 8 patients probably was another associated autoimmune paraneoplastic complication.

Adult↗
PubMed1991

Myasthenia gravis in childhood and infancy. Usefulness of electrophysiologic studies.

The diagnostic yield of electrodiagnostic tests was evaluated in 21 children with myasthenia gravis (MG). Twelve children had juvenile autoimmune MG, four had neonatal MG, four had congenital MG, and one had MG with arthrogryposis. Repetitive stimulation (RS) of the ulnar nerve was performed in every patient, sometimes with sensitization by ischemia. When the RS test was negative, the spinal or facial nerve was tested. In the group with neonatal MG, the RS test disclosed a significant decrement in 75% of the patients. Among the 17 other children, the overall percentage of positive RS tests was 88%. An ulnar nerve RS test was positive in 41% of them. Sensitization of ulnar nerve RS by ischemia improved the diagnostic yield to 66%. A spinal or facial nerve RS test was positive in seven of 10 patients. These results confirmed the diagnostic value of RS, with sensitization by ischemia, when necessary, in childhood MG whenever a careful technique is provided.

Adolescent↗
PubMed1991

Sequential electrodiagnostic evaluation of diabetic neuropathy after combined pancreatic and renal transplantation.

To assess the long-term evolution of diabetic polyneuropathy after a combined kidney-pancreas transplant, an electrophysiological study was performed in 20 diabetic patients before transplant, and 1 (n = 18), 2 (n = 16), 3 (n = 10) and 4 years (n = 5) at a later date. Motor and sensory scores were calculated for conduction velocity and amplitude to determine the physiopathological process. During evolution the scores were not found to be decreasing. Motor and sensory velocity scores were significantly improved (p less than 0.05) 1 and 2 years after the graft, when score values tended to stabilize. Motor and sensory amplitude scores, which are more sensitive for axonal loss assessment were slightly but not significantly improved.

Adult↗
PubMed1991

Unusual amyloid polyneuropathy with predominant lumbosacral nerve roots and plexus involvement.

We report a 25-year-old patient with a progressive asymmetric peripheral neuropathy of the distal lower limbs. Imaging studies showed enlargement of lumbosacral roots, plexus, and proximal sciatic nerve. Sacral plexus biopsy revealed amyloidosis associated with endoneurial edema. Immunohistochemistry with anti-prealbumin, serum amyloid A, and immunoglobulin light chain antisera failed to label the amyloid.

Adult↗
PubMed1990

Clinical validation of antidromic stimulation of the ring finger in early electrodiagnosis of mild carpal tunnel syndrome.

Median and ulnar sensory distal latencies were measured antidromically on the fourth finger in 158 patients (224 hands) with suspected carpal tunnel syndrome (CTS), in 60 normal subjects (100 hands), and in 30 patients (30 hands) who suffered from paresthesiae due to a cervical spondylotic radiculopathy (CSR). The difference between these 2 latencies was less than 0.4 msec in all normals and patients with CSR, while in all of the patients with CTS it was more than 0.5 msec. Median sensory nerve conduction was significantly slower for the fourth than for the second finger in the CTS group, but not in controls. The difference between median and ulnar sensory distal latencies on the fourth finger proved to be the most sensitive of the tested parameters and was the only abnormal one in 20% of the clinically affected hands. The ring finger technique is a quick and easy procedure, which should be recommended in the early diagnosis of mild CTS.

Adult↗
PubMed1989

[Amyloid pseudotumor of the sciatic nerve].

A 60 year-old man complained of numbness and pain in the right lower limb, suggesting lesions of the fifth lumbar and first sacral roots. Sixteen months later, CT showed a tumor of 3.5 cm at the emergence of the first right sacral root. Microscopic examination disclosed an infiltration of the fibers of the nerve by numerous masses of hyaline eosinophilic material which stained with Congo red and produced green birefringence under polarized light. The persistence of congophilic properties of the amyloid deposits after permanganate pretreatment suggested an immunoglobulin origin (AL). A research of amyloid deposit in others viscera: heart, kidneys, digestive tract, was negative. We believe that this is the first reported case of amyloid pseudo-tumor involving a peripheral nerve.

Amyloidosis↗
PubMed1989

[Value of somatosensory evoked potentials in thoraco- brachial outlet syndrome].

INTRODUCTION: Brachial plexus involvement in symptoms of thoracic outlet syndrome (TOS) is often difficult to assess from clinical data. Conventional EMG and nerve conduction studies (NCS) do not seem reliable to all authors. For this reason, our investigations of this syndrome were complemented by study of somatosensory evoked potentials (SEP) in order to compare the results of these different techniques. PATIENTS AND METHODS: Ten patients were studied, all of whom had prominent vascular symptoms which led to their consulting a vascular surgeon. Only one had hand wasting without hypoesthesia. None had cervical rib or cervical spine anomaly. In all cases, diagnosis was confirmed by arteriography or phlebography. Operations were decided on clinical data and results of vascular investigations. Patients were tested with conventional motor and sensitive NCS F-wave studies. Needle EMG was performed in abductor pollicis brevis, first dorsal interosseus or abductor digitiminimi. Their SEP were performed as for controls. Ten controls were studied whose SEP were obtained at Erb's point (N9) and C2 cervical spine level (N13) after percutaneous stimulation of median and ulnar nerves at the wrist on both sides. The criterion of abnormality was the mean of controls + 2.5 SD for latencies. Amplitude was considered as low when it was less than 50% of the contralateral one. RESULTS: For 2 patients EMG, NCS and SEP were abnormal. One had hand wasting and denervation in hand muscles as well as slowed median and ulnar sensory conduction with low amplitude responses. SEP at Erb's point were slightly delayed after ulnar stimulation. No cervical response was obtained after ulnar stimulation. The second one had normal responses at Erb's point but delayed responses at the cervical level. In addition, N13 amplitude after ulnar stimulation was low. Four patients had normal EMG, NCS and SEP. Two patients had normal EMG and NCS, but their SEP was questionable since latencies were normal, even though amplitude was low after median and ulnar stimulation. This was not considered this to be abnormal since it was bilateral. For the remaining 2 patients (F.1), EMG and NCS and Erb's point SEP were normal, but C2 median and ulnar responses were delayed in one case and C2 ulnar response amplitude was very low on one side only in the other. In conclusion, SEP were abnormal for 4 patients out of 10 but gave more information than conventional EMG and NCS for only 2 patients. SEP abnormalities prevailed after ulnar stimulation.

Adult↗
PubMed1988

[Partial recovery of the oculomotor nerve after section and repair during the excision of a tumor].

The authors report the case of a patient having suffered a section of the oculomotor nerve during the excision of a tumor located in the tentorium incisura. The nerve was immediately sutured (end to end anastomosis). After 18 months, a partial recovery of the function of the nerve was seen clinically and on EMG. Ptosis had disappeared and adduction of the eye reappeared. An analysis of available data on the suture of oculomotor nerves is then given: reparation of the third nerve in animals and man give variable and partial results. Partial recovery and aberrant regeneration are explained by the fact that this nerve innervates many muscles and by the absence of ultrastructural systematisation. On the contrary, some still rare studies have indicated that the suture of the fourth and sixth cranial nerves give better results probably because these nerves have a simple ultrastructural organization, are purely motor and innervate only one ocular muscle.

Adult↗
PubMed1988

[Peripheral neuropathies simulating amyotrophic lateral sclerosis in gammopathies].

Particular clinical pictures of ALS may occur during the course of some "benign gammapathies". We observed 12 patients (age range 57 to 74 years; 9 men-3 women) with initially benign gammapathy (9 IgG, 1 IgA, 2 IgM) associated to a clinical picture of progressive anterior horn and pyramidal tract involvement. These cases led us to recognize some particularities of gammapathy-associated ALS: Relative frequency of asymmetrical clinical manifestations, rarity of bulbar signs; Decrease of sensory nerve conduction velocities without evidence of sensory clinical symptoms (8 out 9); Increase CSF protein content including the monoclonal component, axonal degeneration and immunostaining evidence of the paraprotein fixation observed on nerve biopsies (5 out 7 cases). Association of ALS and gammapathy is not fortuitous as shown by epidemiology, experiments, pathology and effects of different immunological treatments as related in this study. Demonstration of infra-clinical neuropathy face to a clinical syndrome of ALS should prompt too careful screening for a gammapathy.

Aged↗
PubMed1987

Congenital Lambert-Eaton myasthenic syndrome.

A 4 year old girl had been hypotonic and areflexic since birth with delayed milestones in motor development. Repetitive stimulation at high rates performed at 3 years elicited an incremental response typical of the Lambert-Eaton Syndrome.

Action Potentials↗
PubMed1986

[Clinical amyotrophic lateral sclerosis syndromes in gammapathies: clinical, electrophysiologic and histoimmunologic aspects].

Eleven patients with motor neuron disease associated with a monoclonal gammopathy were studied. One patient had a previously known multiple myeloma. In the other patients neurological symptoms preceded diagnosis of the gammopathy by one month to 8 years. They were 5 multiple myeloma, 1 macroglobulinemia, 1 chronic lymphatic leukemia, 1 lymphoma and 3 benign monoclonal gammopathies. EMG and motor conduction velocities results were consistent with anterior horn cell disease but sensory conduction studies were abnormal in seven cases out of eight. Superficial peroneal nerve biopsy performed in all patients confirmed peripheral nerve involvement. The relations between gammopathy, clinical symptoms and electrophysiological data are discussed. The interest of sensory conduction studies in every patient with motor neuron disease is emphasized.

Aged↗
PubMed1985

[Electro-clinical data in medullary forms of the Chiari malformation without syringomyelia].

The electrophysiological findings in 18 patients with Arnold-Chiari malformation (ACM) revealed by spinal symptoms excluding syringomyelic syndrome (Brown-Sequard syndrome, paraparesis with or without posterior column involvement, motor neuron syndrome or more complex myelopathies) are reported. In 16 cases, EMG disclosed abnormalities consistent with lesion of anterior horn cells restricted to upper limb in 7 cases, and generalized in 9 cases. In 2 cases, motor and sensory conductions were abnormal. The occurrence of such abnormalities in patients with ACM is emphasized as they could lead to confusion with amyotrophic lateral sclerosis or spinal muscular atrophy. Neuroradiological studies are therefore necessary owing to possible surgical treatment. The hypothesis relating lower motor involvement and ACM are reviewed.

Adult↗
PubMed1985

Intramedullary sarcoidosis of the cervical spinal cord.

A 26-year-old male with a history of pulmonary sarcoidosis showed clinical, myelographic and intra-operative evidence of a C5-C6 spinal cord tumour, which was diagnosed by biopsy as a pure intramedullary granuloma. Among the 29 published cases of histologically proven cord sarcoidosis, only five presented with pure parenchymatous infiltration without meningeal involvement. Corticosteroids are the most useful therapy, and surgery is indicated only for minimal biopsy when the parenchyma is invaded.

Adult↗
PubMed1984

[Normal sensory nerve conduction velocities of the median and ulnar nerves in children from birth to 15 years].

Conduction velocity of the fastest fibres in sensory nerves (SCV), amplitude and shape of the sensory evoked potentials (SEPs) were studied in 94 normal children aged 5 days up to 15 years. Surface electrodes were used both for nerve stimulation and sensory evoked potential recording. Normal minimal value in young adults is reached between 2 and 4 years of age, earlier in the proximal segment of the nerve (wrist-elbow) than in the distal segment (digit-wrist). Amplitude of the median SEP at the wrist increases about 155% during the first 2 years of life; this increase becomes more progressive and moderate from 2 to 15 years of age. At the elbow, the SEP has a smaller amplitude and is made of two separate peaks in 80-100% of the children between 6 months and 10 years of age. The presence of those two separate components lends substance to the view that there are two groups of fibres with different degrees of maturation. Methodology and results are discussed along with previous data from the literature.

Adolescent↗