Biomedical subjects

E B Hilton

Publications and source records attributed to E B Hilton.

4 recordsLinked to original sources

PubMed1989

Across-elbow ulnar nerve sensory conduction technique.

Compression of the ulnar nerve across the elbow is one of the most common of the entrapment syndromes. The usual method of electrodiagnostic evaluation is to determine the motor nerve conduction for this nerve segment. Normal values for sensory conduction and amplitude changes for this nerve segment have been rarely reported, and clinical usefulness of the sensory techniques remains unclear and controversial. This study reports an ulnar nerve sensory technique for the across-elbow segment. Normal data with the elbow flexed to 90 degrees and for a 10-cm nerve segment were 1.8msec, mean +2SD for sensory latency measured to onset and 1.9msec to peak. Comparable motor latency was 2.0msec. Sensory amplitude decrement across the elbow was 41% mean +2SD and 7.6% for the comparable motor amplitude decrement. Three cases of ulnar nerve compression at the elbow are reported, exemplifying that this technique appears to be useful particularly in patients with sensory, as opposed to mixed (sensory and motor), clinical abnormalities.

Adult↗

PubMed1986

Carpal tunnel syndrome in the nonparetic hands of hemiplegics. Stress-induced by ambulatory assistive devices.

Three patients who had earlier sustained an acute stroke were admitted to a rehabilitation bed service. Clinically, they developed symptoms suggestive of carpal tunnel syndrome (CTS) in their nonparetic hands during a progressive ambulation training program which included ambulatory assistive devices. In each patient, the diagnosis was confirmed by electrodiagnostic evaluation. Two of the three patients were subsequently provided with forearm platform attachments for their assistive devices, and cock-up wrist splints, in an attempt to decrease compression of the median nerve. Despite these measures, both remained symptomatic and had electrodiagnostic evidence of progressive CTS. They were referred for surgical decompression of the median nerve. The third patient had resolution of symptoms when she became able to ambulate without need of an assistive device. These cases are examples of CTS secondary to excessive pressure in the nonparetic hands of hemiparetic patients, believed to occur more frequently than is clinically recognized.

Aged↗

PubMed1986

Proximal forearm ulnar nerve conduction techniques.

Compression of the ulnar nerve across the elbow is a common clinical diagnosis frequently referred for electrodiagnostic evaluation. Motor conduction studies with recording over the abductor digiti minimi and stimulating proximal and distal to the ulnar notch have been the standard technique employed in these evaluations--mean, 60.0 m/s; SD 5.0 m/s. Two other techniques are described, with data from normal subjects, recording from proximal forearm muscles. One technique is a refinement of a previously described method recording from the flexor carpi ulnaris--mean, 63.0 m/s; SD, 4.7 m/s. The second is a newly developed technique recording from the flexor digitorum profundus--mean, 63.0 m/s; SD, 5.5m/s. All three methods were found to have a small range of comparable normal values, and appear to be easily and quickly performed with reliable and reproducible information. The techniques described enhance specific localization of ulnar nerve lesions, and may prove useful when more distal recording sites are unavailable.

Action Potentials↗

PubMed1984

The physiatrist as primary physician for patients on an inpatient rehabilitation unit.

Eighty-two patients admitted to a predominantly geriatric inpatient rehabilitation unit were followed throughout their stay in order to document their need for medical management. Their average age was 74.1 years and mean length of stay was 27.9 days. A total of 302 indications for medical intervention (3.7/patient) were found. In addition there were 2.8 medication changes/patient found when comparing admission to discharge medications, and 0.7 medications/patient prescribed for intercurrent illnesses. Actual documented loss of planned therapy time was found 21 times, involving 19 patients but exceeded 1 day in only six patients. Fifty-eight patients were ultimately discharged home, 14 were discharged to nursing homes (7 for social reasons), and 10 were transferred to an acute general hospital. Adverse drug reactions occurred in 27% of the patients and incidence rate paralleled the number of medications prescribed for the patient. This study indicates that the physiatrist on an inpatient rehabilitation unit must function as team manager or program director, and as the patient's primary physician. By managing medical problems effectively, the physician limits the loss of therapy time, thus shortening the length of stay and enabling the patient to continue to participate in his rehabilitation program.

Aged↗