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Biomedical subjects

T K McGonagle

Publications and source records attributed to T K McGonagle.

2 recordsLinked to original sources

Spectrum of patients with EMG features of polyradiculopathy without neuropathy.

We reviewed the medical records of 233 patients having electrodiagnostic evidence of polyradiculopathy. Patients with polyneuropathy or incomplete diagnostic evaluation were excluded. A clinical diagnosis was secured in 92 of the 118 remaining patients. Patients were separated into three groups based upon the anatomic location of root involvement: extradural (55), intradural-extraaxial (23), and intraaxial (14). Collectively, patients with intradural-extraaxial disorders had earlier disease onset, shorter symptom duration, and a higher disability score compared with the intraaxial or extradural groups. Pain was an initial complaint in 50 of 55 patients with extradural lesions, 20 of 23 with intradural-extraaxial disease, but only in 4 of 14 with intraaxial involvement. CSF abnormalities and reduced compound muscle action potential amplitudes were more common in the intradural-extraaxial group. We conclude that the anatomic localization of root involvement in patients with polyradiculopathy can be suggested by a combination of clinical, laboratory, and electrodiagnostic features.

Diagnosis, Differential↗

Sequential electrodiagnostic abnormalities in acute inflammatory demyelinating polyradiculoneuropathy.

We reviewed 180 electroneuromyographic (EMG) studies from patients with acute inflammatory demyelinating polyradiculoneuropathy. EMG criteria suggestive of demyelination were met during the first 5 weeks in 87% of patients; an additional 10% had indeterminate electrodiagnostic evaluations, and 3% demonstrated axonal degeneration only. Motor nerve conduction abnormalities initially predominated, with the nadir of abnormality occurring at week 3. Sensory nerve conduction abnormalities peaked during week 4 and were atypical for polyneuropathy, with 52% of patients having normal sural but abnormal median sensory studies, perhaps reflecting distal nerve involvement. Delayed sensory abnormalities may reflect, in part, secondary involvement related to increased intraneural edema accentuated by compression at sites of anatomic vulnerability. Fibrillation potentials and increased polyphasia appeared between weeks 2 and 5 in proximal and distal muscles simultaneously, which is consistent with either random axonal degeneration at any point along the axon or distal involvement. Resolution of conduction abnormalities began between weeks 6 and 10, with increased mean motor-evoked amplitude best reflecting functional clinical recovery.

Action Potentials↗