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Ultrasound thermotherapy effect on the recovery of nerve conduction in experimental compression neuropathy.

Bilateral tibial nerves of 18 albino rats were mechanically compressed between knee and ankle. Beginning on the fifth day after compression, ultrasound thermotherapy of 0.5 or 1.0watt/cm2 was applied over the area of nerve compression in one limb for one minute three times per week. The other side (control) was not treated. Motor distal latency (DL), motor nerve conduction velocity (NCV) of the segment with nerve compression, and amplitude of the evoked compound muscle action potential (ACMAP) were measured before and immediately after nerve compression and two or three times per week after compression. The recovery rates of NCV and ACMAP of the tibial nerve treated with ultrasound of 0.5watt/cm2 were significantly faster than those of the control nerve. There was no significant change in the recovery rate of DL. However, if ultrasound of 1.0watt/cm2 was applied, the recovery rate of ACMAP of the treated nerve was slower than that of the control nerve. There were no significant changes in the recovery rates of DL and NCV. Low doses of ultrasound thermotherapy may facilitate recovery of compression neuropathy, but higher doses may induce an adverse effect.

Action Potentials↗

Bell's palsy: delayed recovery after one year with surgical confirmation.

An instance of Bell's palsy with complete flaccid peripheral facial paralysis at one year with surgical confirmation by total facial nerve decompression and incision of the intratemporal facial nerve sheath confirmation is presented. This individual, with a most unusual duration of total facial paralysis in an instance of Bell's palsy, nevertheless developed eventual recovery typical of the delayed recovery from Bell's palsy, with considerable improvement in facial symmetry at rest, eyelid closure, and facial motion.

Eyelids↗

Postoperative ulnar neuropathy.

Although compressive ulnar neuropathy developing during surgical procedures under general anesthesia has been recognized, clinical and electrophysiological features of this neuropathy have been incompletely described. During the past two years, we have seen eight patients with this complication, mainly following intra-abdominal or intrathoracic operations. Neuropathy was associated with a persistent severe deficit during a mean follow-up of 23.5 months (range, six to 96 months) after operation. Electrophysiological studies verified substantial Wallerian degeneration in the majority of patients. Clinical and electrophysiological data, as well as intraoperative findings in some patients, suggest that compression occurred at the cubital tunnel. These patients with ulnar neuropathy had a particularly poor prognosis, whether treated surgically (decompression or transposition) or medically. Prevention of ulnar nerve compression during major operations therefore assumes paramount importance.

Action Potentials↗

[Recurrent familial neuropathy due to compression (author's transl)].

The authors describe a family, of which 13 members had peripheral neuropathy manifesting as episodes of paralysies usually provoked by minor compression of nerve trunks. Nerve and muscle biopsies in two patients, demonstrated many thickenings of the myelin sheath ("tomacula"). Electron microscopy investigations are used as a basis for discussing the origin and place of this affection among other hereditary neuropathies.

Adolescent↗

[Controlled trial of isaxonine in traumatic or ischaemic (compression) neuropathies (author's transl)].

Fifty patients showing one or more impairments to large nerve trunks due to trauma or ischaemia received, after drawing lots, either isaxonine or a placebo. The evaluation criteria of the recovery were both clinical (testing of muscles, sensory disorders, vegetative disorders, tendon reflexes, tonicity, amyotrophy) and electrophysiological (electromyogram, conduction velocity, distal latency time, H reflex and H/M index). This study shows two major elements: the action of isaxonine shortens healing time (45-90 days instead of 120-150 days) and isaxonine allows neurological recovery to resume at neurologic level whereas the situation was dating back more than three months.

Clinical Trials as Topic↗

Treatable peripheral neuropathies.

A comprehensive survey of peripheral neuropathies from the therapeutical standpoint is given. Curable and treatable neuropathies are distinguished. Further sections deal with the treatment of painful neuropathies, of acrodystrophic neuropathy, genetic advice, rehabilitation measures and, finally, drugs stimulating axonal regeneration. The differential diagnosis of the individual diseases is outlined, the therapies are described in detail. Application of trophic and growth factors may yield future improvement in the treatment of polyneuropathies.

Avitaminosis↗