PubMed Health⌕ Search

Biomedical subjects

M Niewiadomska

Publications and source records attributed to M Niewiadomska.

At least 19 recordsLinked to original sources

Motor evoked potential studies in Creutzfeldt-Jakob disease.

OBJECTIVES: Motor evoked potentials (MEPs) were recorded in 7 cases of Creutzfeldt-Jakob disease (CJD) to asses the involvement of pyramidal motor pathways in these cases. The diagnosis of CJD was confirmed by autopsy in 5 cases and based on clinical data in two cases. METHODS: Transcranial (MEP-cortex), root magnetic (MEP-root) and electrical stimulation of peripheral nerves (F-wave, direct M-response) were performed. The cortical excitability threshold, F-wave frequency, MEP amplitudes, peripheral motor conduction velocity, standardized distal latencies and central, root, and F-wave conduction times were evaluated. RESULTS: The results of MEP testing were markedly abnormal. Cortical excitability thresholds were elevated, MEP amplitudes were reduced while the conduction function was rather preserved. The features of functional disturbances and/or loss of upper and lower motor neurons were revealed. They correlated with the advancement of key clinical CJD symptoms (progressive dementia, extrapyramidal and cerebellar signs, myoclonic jerks, mutism and typical periodic EEG changes), while motor lesion signs might only be slight or absent. CONCLUSIONS: Conduction slowing, if present, seemed to be secondary to axonal lesion.

Adult↗

Peculiarity of soleus motor potentials evoked by transcranial magnetic stimulation and electrical stimulation of tibial nerve.

OBJECTIVE: To reveal and discuss the peculiarities of soleus muscle in comparison with electrophysiological features of other leg muscles. METHODS: Vastus lateralis (L3), tibialis anterior (L4), extensor digitorum brevis (L5) and soleus (S1) muscles were tested at rest. Transcranial magnetic stimulation (TMS) combined which electrical stimulation of relevant peripheral nerves were applied. Cortically evoked motor potentials (C-MEP), peripheral compound muscle action potential (CMAP) and F-wave were recorded. Estimating F-wave conduction time allowed to calculated the central conduction time (CCT-F) within the cortex-spinal motoneurones segment for each muscle. RESULTS: One could expect that the lower spinal metameric representation of the muscle the longer a corresponding CCT-F. However, a study of 30 healthy subject (60 right and left muscles) reveals a relatively short CCT-F for the soleus muscle. Moreover, the mean amplitude of soleus C-MEP is the lowest, CMAP and F-wave amplitude are the highest and standardised distal motor latency is the longest compared to the analogous parameters for the other muscles. CONCLUSIONS: The reason for these special features can be attributed probably to a different structure and innervation of the soleus (mainly red, slow, tonic muscle) in contrast to the tibialis anterior and extensor digitorum brevis (mainly white, fast, phasic muscle).

Adolescent↗

Cortical excitability threshold for distal limb muscles in transcranial magnetic stimulation. Method--normative values.

Transcranial magnetic stimulation was carried out in 30 healthy subjects, aged 20 to 55 and 156 to 180 cm tall, in whom cortical excitability threshold was determined for musculus (m.) abductor digiti minimi (ADM) and m. extensor digitorum brevis (EDB). The lowest stimulus intensity causing in the muscle a reproducible potential of an amplitude of 0.1 mV was adopted as the threshold value. The intensity of the stimulus was noted as a percentage of maximum stimulator output, defined as 100% (Magstim 200). In the stimulation of cortical areas for ADM, a circular coil (2.0T-530 V/m) was used while the in case of EBD, a double-cone coil (1.4T-660 V/m) was used. The threshold was noted while the muscle was relaxed and during weak voluntary contraction. The application of the double-cone coil allowed us to obtain for foot muscles similar threshold values as for hand muscles with a circular coil. It was confirmed that the threshold declines with voluntary contraction of the muscles under investigation. Normative values were prepared, with the norm, limits of the norm, outlier values and pathological markers being distinguished.

Adult↗

The F-wave in the vastus lateralis M. and the segmental motor conduction times for L2/L4 motoneurons.

The study was performed in 30 normal subjects. Electrical stimulation was applied to the femoral nerves and the muscle evoked potential (CMAP) together with their late components were recorded from the vastus lateralis muscle bilaterally (60 nerves). Features of the late component demonstrating its antidromic nature (F-wave) were proved. Additionally, in each subject transcranial cortical (C) magnetic stimulation and root (Rx) magnetic stimulation at the level of the L3-L4 was applied. The measured latencies of respective motor evoked potentials C-MEP (relaxed muscles), CA-MEP (activated), Rx-MEP as well as the latencies of peripheral CMAP and F-wave allowed the calculation of the derived parameters, i.e. segmental times of motor conduction: central, root and peripheral. The normative values were established. The F-wave measurement also allowed for the calculation of the so-called real central conduction time, which proved to be significantly shorter than the corresponding times previously established for the lower situated L4/S1 motoneurons. This finding suggests usefulness of the method in the precise diagnosis of the lumbosacral spinal enlargement.

Adult↗

Porphyric polyneuropathy and its pathogenesis in the light of electrophysiological investigations.

Twenty-four patients with acute intermittent porphyria were examined by means of routine electromyographic (EMG) tests, measurements of motor and sensory conduction in peripheral nerves and stimulation fatigue tests. The EMG results gave evidence of an initial, reversible disorder of function of the peripheral neuron, only sometimes followed by evidence of axonal degeneration of the "dying back" type. In stimulation fatigue tests there was some evidence of potentiation but none of fatigue. Attention is drawn to some analogies between the electrophysiological changes in porphyric polyneuropathy and in botulism. It seems that the pathogenesis of porphyric polyneuropathy may be dependent upon a block of cholinergic endings.

Acute Disease↗

[Neuromuscular excitability and conduction in cases of hypoparathyroidism].

The patients with hypoparathyroidism were studied carrying out: a) tetanic test (PT) for assessment of the degree of neuromuscular excitability and b) double stimulus test (PBP) for assessment of the efficiency of neuromuscular conduction. In six patients low values of calcium, high values of phosphorus and normal values of magnesium were found. In the remaining patients calcium level was decreased also but the phosphorus level was normal, while that of magnesium was low. In all patients the PT was normal while the PBP showed in the first group reduced efficiency of conduction and in the remaining cases increased neuromuscular conductivility. The possible interpretation of obtained results is discussed.

Adolescent↗

[Clinical picture of spinocerebellar ataxia type I (SCA1)].

Spinocerebellar ataxia is a group of diseases with autosomal dominant inheritance heterogenous both clinically and genetically. So called dynamic mutations underlie most these nosological units. The clinical patterns of various SCA types have not yet been defined completely. The purpose of the present report was description of the typical symptoms and signs of type 1 SCA. Seventeen patients from 13 families (M-2, F-15) were studied clinically in detail. The diagnosis was confirmed by DNA analysis. The assessment included neurological status, cognitive functions, the results of EEG, EMG, SEP, VEP, BAER and MRI examinations. The pedigrees indicated autosomal dominant inheritance pattern. The mean age at onset was 35.5 +/- 6.8 years (range 23-45 years) and it suggested negative correlation with the number of CAG repetitions. Cerebellar syndrome limb and truncal, ataxia and dysarthria was present in all cases. Six patients had nystagmus, 3 had slow saccades, 2 had gaze limitation upward, and lateral and 6 had dysphagia. Signs of pyramidal system involvement were found in 10 cases, one had athetotic movements, one had orthostatic hypotension. Two patients had dementia features, 9 had some decline of intellectual functions, mainly with difficulties of memorization, learning and concentration. In 16 cases MRI demonstrated vermis atrophy and atrophy of cerebellar hemispheres, 14 had fourth ventricle dilatation, 8 had flattening of pons base, 8 had narrowing of cervical spinal cord, 8 had dilated CSF spaces over frontal lobes and in 6 cases lateral ventricles were dilated. Electrophysiological peripheral nervous system investigations showed in 16 cases long-standing damage to the motor and sensory peripheral neurons at the level of nerve trunks, more pronounced in sensory nerves. In 13 cases peripheral neuron damage was subclinical. SEP showed in all patients disturbed function of ascending sensory pathways at peripheral and spinocortical levels.

Adult↗

[Computer-assisted evaluation of the status of the peripheral nervous system in alcoholics].

The authors present the principles of work of a computer system destined for evaluation of the results of routine electrophysiological examination of two muscles and four sensory nerves in alcohol-dependent subjects. The range of examinations and the programme based on discrimination analysis make possible, as shown in own investigations, an objective and complete evaluation of the state of the peripheral nervous system in these subjects. The programme is owned by the EMG laboratory of the Institute of Psychiatry and Neurology in Warsaw where it was introduced for clinical diagnosis, but it may be made available to other persons interested in these problems. An electromyograph with a stimulator with current exit averager and minicomputer, e.g. Commodore 64 with a printer are necessary.

Action Potentials↗