Biomedical subjects
Publications and source records attributed to J A Liveson.
Lesions of the suprascapular nerve can occur at the supraspinatus notch (SSN) or at the spinoglenoid notch (SGN). Electromyographic (EMG), evaluation of the infraspinatus, and especially the supraspinatus muscles distinguishes SGN from SSN lesions. Three cases of SGN lesions, which are more common than SSN lesions, are presented.
Three cases are presented of thoracic radiculopathy related to collapsed thoracic vertebral bodies. In all cases proximal weakness of the legs was present, leading to the diagnosis of myopathy in two cases. Sensory symptoms were present in two cases. In one, anterior thigh paresthesias lead to a diagnosis of meralgia paresthetica. This diagnostic entity must be remembered if appropriate corroborative tests are to be performed. In cases of trauma this diagnosis should be considered if thoracic vertebral collapse is present. Conversely, an evaluation of proximal weakness should include a review of thoracic radiographs for vertebral collapse, especially in the presence of sensory findings in the lower abdominal or proximal thigh region.
Electrodiagnostic examination of 11 patients with shoulder dislocation revealed nerve damage not previously reported. Although axillary nerve lesions were most common, posterior cord and musculocutaneous nerve damage occurred each in five cases. The mechanism of injury was important. The most surprising patterns were associated with blunt injury or recurrent spontaneous dislocation.
Organotypic cultures of dorsal root ganglion cells revealed neuronal toxicity when exposed to myoinositol at doses of 1090 to 109 micrometer (500 to 50 microgram/ml). The ultrastructural changes consisted of membranous cytoplasmic bodies at high concentrations and dense bodies at lower concentrations. There were no changes at 0 to 22 micrometer (0 to 10 microgram/ml). This range of neurotoxicity parallels the levels of myoinositol found in the serum of uremic patients. Myelin loss occurred in a pattern suggesting "secondary demyelination," similar to the pattern seen in uremic neuropathy. The relevance as a possible model for uremic neuropathy is discussed.
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Atrophy of muscles innervated by the lower cervical cord is a well-known feature in patients with foramen magnum tumours. Electromyographic evidence of denervation in the atrophic muscles is presented. The significance and possible mechanisms are reviewed and discussed.
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