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Biomedical subjects

M González-Hidalgo

Publications and source records attributed to M González-Hidalgo.

8 recordsLinked to original sources
PubMed1998

[Neurophysiological evaluation of the pelvic floor].

INTRODUCTION: Methods for investigating the pelvic floor neurophysiological means are described. These include recording electromyographic activity of pelvic muscles and sphincter, under urodynamics studies or to assess the integrity of innervation of the muscle, pudendal and dorsal nerve of the penis conduction velocity, sacral reflexes and afferent and efferent conduction studies between the cortex and the pelvic floor, under our hospital protocol and a description of the major method from published reports and the clinical applications (Neurogenic bladder, faecal incontinence, male impotence) are discussed.

Anal Canal↗
PubMed1998

[Carpal tunnel syndrome: clinical and neurophysiological correlation: review of 100 cases].

INTRODUCTION: The diagnosis of carpal tunnel syndrome (CTS) continues to be neurophysiologically and clinically controversial. This study attempts to find the correlation between the subjective symptomatology and the neurophysiological affectation, establishing a diagnostic guide for the family doctor in order to recognize early CTS for referral to the specialist doctor. PATIENTS AND METHODS: After a sample of 100 cases with clinical suspicion of CTS, a clinical evaluation was made with the symptoms (paresthesias, pain, loss of strength), signs (Tinel, Phalen), and the neurophysiological evaluation with electroneurography (ENG) of the median and cubital nerve (sensory velocity (SV), motor distal latency (MDL)), and electromyography (EMG) of tenar eminence muscles. With this data an epidemiological study was made with correlation between the clinical and neurophysiological parameters. RESULTS: The patients with pain, loss of strength and Tinel's sign had significant alteration of the parameters of ENG and EMG. Tinel's sign had a sensitivity (SE) = 30.1% and a specificity (SP) = 73% for MDL, a SE = 32.5% and a SP = 88.2% for SV. Phalen's sign had a SE = 22.2% and a SP = 94.6% for MDL, a SE = 18.1% and a SP = 94.1% for SV. CONCLUSIONS: The guide to recognize clinically the patients which must be studied neurophysiologically that have a high probability to suffer CTS is: diagnosis for motor alteration, pain (SE = 79%), loss of strength (SP = 86%) and Phalen's sign (SP = 94.6%). Sensory alteration: paresthesias (SE = 97%), Tinel's sign (SP = 88.2%) and Phalen's sign (SP = 94.1%).

Adult↗
PubMed1990

Rett's syndrome: a neurophysiological study.

Thirteen girls with Rett's syndrome were evaluated with wakefulness and sleep polygraphic records and EMG studies. The main EEG findings were paroxysmal activity during sleep, multifocal in younger and unifocal in older girls, and "pseudorhythmic flattening". In the opinion of the authors, the changes with age are related to evolution of the disease or maturational changes of CNS. The affectation of the peripheral nervous system was demonstrated in almost half the patients.

Age Factors↗
PubMedDate not supplied

[Protocol of intraoperative neurophysiological spinal cord monitoring].

INTRODUCTION: The consequences derived from medullar harm caused during several spinal cord surgical interventions can often be catastrophic for the patient, even more taking into consideration that many of them are young. DEVELOPMENT: This problem is observed specially at interventions of spinal malformations (kyphoscoliosis), but also during other surgical techniques like fractures, degenerations, spinal tumors and aortic lesions. The use of somatosensory evoked potentials (SEP) began at late 70's, as a method to monitorize spinal cord function during surgery; years later, motor evoked potentials (MEP) joined this option, giving us direct information about the functioning of posterior spinothalamic tract (posterior column) and lateral corticospinal tract (pyramidal tract), respectively. This has motivated that, although the degree of surgical difficulty and complexity of spinal instrumentation have raised, the actual percentage of neurological complications derived from them has decreased. CONCLUSIONS: This article describes the intraoperative spinal cord monitoring protocol followed at Hospital Clínico San Carlos of Madrid, Spain, which includes the making of SEP and MEP, the latest according to the translaminar stimulation technique.

Evoked Potentials, Motor↗
PubMedDate not supplied

[Intraoperative electrical cortical stimulation in cerebral lesions].

INTRODUCTION: Intraoperative brain mapping is used during neurosurgery in functional cortex to facilitate the extent of cortical resection and to identify nonfunctional tissue to remove subcortical lesions. OBJECTIVE: To describe the intraoperative brain mapping protocol that has been utilized in the Hospital Clínico San Carlos of Madrid, Spain. Detailed somatotopic motor, sensitive and language localization is possible using direct cortical electric stimulation in the awake patient. CONCLUSIONS: Intraoperative brain mapping is a surgical adjunct used during lesionectomy in functional cortex. In addition to preserving functions, the other essential goal is to achieve a radical removal while attempting to minimize the associated morbidity.

Brain Diseases↗
PubMedDate not supplied

[Neurophysiological studies of the neuromuscular junction].

INTRODUCTION: The role played by neurophysiological studies (NPS) in the diagnosis of diseases affecting neuromuscular transmission (NMT) is based on the study of the failure of muscle fibres to achieve a sufficient degree of depolarisation for the junction potential to reach the appropriate threshold and attain a muscular action potential. This totally or partially blocked impulse will give rise to different types of responses in neurophysiological tests. AIMS: To analyse the different NPS as diagnostic methods in diseases that affect NMT. DEVELOPMENT: The article offers a review of the concept of the safety margin at the neuromuscular junction and a description of the most common neurophysiological techniques currently in use--repetitive stimulation, as well as conventional or single fibre electromyography (EMG) with voluntary activation or axonal electrical activation. The most frequent findings in diseases affecting NMT are also discussed. CONCLUSIONS: NPS will be useful to confirm or reject the clinical diagnosis, to exclude other concomitant neuromuscular diseases, to establish whether the process is pre- or post-synaptic, to monitor the clinical course of the disease (when it is both natural or in response to the medical or surgical treatment) and also to enable the physician to determine the status of NMT in cases of clinical remission, as well as to detect subclinical disorders. Single fibre EMG studies are the most sensitive method of neurophysiological diagnosis when dealing with these diseases.

Action Potentials↗
PubMedDate not supplied

[Indications of neurophysiological studies in lower back pain].

INTRODUCTION: Between 60% and 90% of people in developed countries experience lower back pain at some time in their life and it is therefore one of the most frequent reasons for visiting the specialist in neurology. On many occasions there is no correlation between the symptoms, the clinical pathology and the radiological features. AIM. To determine suitable indications and the appropriate time to conduct neurophysiological studies in lower back pain. DEVELOPMENT: We review the neurophysiological techniques that are most commonly used today and the most frequent findings in patients with acute, subacute or chronic lower back pain, and acute or chronic lumbar-radicular pain. CONCLUSIONS: There is no scientific evidence to prove that neurophysiological studies provide information that modifies the conservative treatment that must be established in patients with acute, subacute or chronic lower back pain, and acute lumbar-radicular pain. In patients with subacute or chronic lumbar-radicular pain, the first neurophysiological studies must be conducted between three weeks and six months after the onset of symptoms. Electromyography is the most sensitive neurophysiological test. Neurophysiological studies are carried out provided that their findings involve changes in the patient's therapeutic attitude, in the pre-operative evaluation and to confirm the extent of injury; they therefore offer prognostic data.

Diagnostic Techniques, Neurological↗