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Biomedical subjects

H W Sander

Publications and source records attributed to H W Sander.

At least 37 records · Page 2Linked to original sources
PubMed1998

Accessory deep peroneal neuropathy: collision technique diagnosis.

Accessory deep peroneal nerve (ADPN), a common anatomic variant, is traditionally suspected when common peroneal nerve stimulation evokes a greater amplitude extensor digitorum brevis compound muscle action potential than deep peroneal nerve (DPN) stimulation. Posterolateral ankle stimulation over the ADPN is confirmatory. We report a rare patient with ADPN neuropathy in whom the collision technique was necessary to confirm the presence of an ADPN and to distinguish between neuropathy of the ADPN and the DPN.

Adult↗
PubMed1998

Orthostatic tremor: an electrophysiological analysis.

Orthostatic tremor (OT) is a clinically defined syndrome of leg tremor while standing. Controversy surrounds whether OT is a distinct syndrome or is an essential tremor (ET) variant. We report two patients with OT. Electrophysiological testing included polymyography, accelerometry, nerve conduction, and evoked potential studies. The effects of various maneuvers and body positions on the tremor were assessed. The findings included rapid (15-17 Hz) lower-extremity tremor burst frequency evoked by standing but not by walking or swaying; rapid upper-extremity burst pattern synchronous with lower-extremity bursts; and failure of electrical stimulation or mental concentration to "reset" the tremor. Additionally, there was the novel finding of accelerometric recordings in the legs revealing the same rapid frequency (16-17 Hz) as the electromyographic tremor bursts. Some prior reports have suggested that OT is related to ET by emphasizing a considerable disparity and variability between the accelerometric tremor frequency and the electromyographic burst frequency. In our patients, however, the rapid (15-17 Hz) accelerometer-recorded tremor synchronous with the electromyographic bursts, and also the clinical improvement with clonazepam but not beta blockers or mysoline, and the lack of a family history of ET provide support that OT is distinct from ET.

Aged↗
PubMed1998

Spontaneous resolution of subdural hematoma. MRI findings.

A 33-year-old man suffered a traumatic subdural hematoma with complete spontaneous resolution, as demonstrated by computed tomography scanning and magnetic resonance imaging. After resolution, there was obliteration of the subarachnoid space on the affected side, giving rise to relative dilation of the subarachnoid space over the uninvolved convexity. A resolved subdural hematoma should be considered in the differential diagnosis of such an asymmetry.

Accidental Falls↗
PubMed1998

A 60-year-old woman with weakness, fatigue, and acute respiratory failure: case report and discussion of the differential diagnosis.

A 60-year-old woman with chronic progressive fatigue, diurnal somnolence, proximal muscle weakness, and dyspnea developed acute respiratory failure when given supplemental oxygen. Hypoventilation secondary to neuromuscular dysfunction was suspected by the critical care specialist. Neurologic consultation and supportive laboratory evaluations led to the diagnosis of acid maltase deficiency, which was confirmed by muscle biopsy. The discussion includes a literature review that describes the pathophysiology and treatment of this rare muscle enzyme deficiency disorder. Acid maltase deficiency should be suspected in any adult presenting with hypoxemia, fatigue, and acute respiratory failure.

Acute Disease↗
PubMed1997

Median-ulnar anastomosis to thenar, hypothenar, and first dorsal interosseous muscles: collision technique confirmation.

Median-ulnar anastomosis (Martin-Gruber anastomosis; MGA) is traditionally diagnosed based upon changes in compound muscle action potential (CMAP) amplitude following proximal stimulation. We describe a rare patient with a MGA innervating thenar, hypothenar, and first dorsal interosseous muscles. Proximal stimulation, however, evoked CMAPs with striking changes in morphology and area but only minimal amplitude changes, due to concomitant diagnoses of carpal tunnel syndrome and polyneuropathy. Collision studies were therefore required for diagnostic confirmation of the MGA.

Action Potentials↗
PubMed1996

AAEM case report #13: diabetic amyotrophy.

A case fulfilling the criteria for the diagnosis of diabetic amyotrophy is reported. Based on the clinical and electrodiagnostic features, it is concluded that diabetic amyotrophy is a recognizable clinical entity that can be differentiated from other diabetic neuropathies. The site of the lesion and the pathogenesis in diabetic amyotrophy remain controversial. The course of the illness is variable with gradual, but often incomplete, improvement.

Aged↗
PubMed1996

Diabetic amyotrophy: current concepts.

Diabetic amyotrophy is a disabling illness that is distinct from other forms of diabetic neuropathy. It is characterized by weakness followed by wasting of pelvifemoral muscles, either unilaterally or bilaterally, with associated pain. Sensory impairment is minimal in the cutaneous distribution sharing the same root or peripheral nerve as affected musculature. Most commonly, the onset is in middle age or later, although it may occur in youth. A concomitant distal predominantly sensory neuropathy may be present. Electrodiagnostic studies are most often consistent with a neurogenic lesion attributable to a lumbosacral radiculopathy, plexopathy, or proximal crural neuropathy. The natural course of the illness is variable with gradual but often incomplete improvement. The site of the lesion and the pathogenesis of diabetic amyotrophy remain controversial. Recent studies suggest a role for immunomodulating agents in certain types of diabetic neuropathy, including diabetic amyotrophy.

Brachial Plexus Neuritis↗
PubMed1996

Heat-sensitive myotonia in proximal myotonic myopathy.

Two siblings with proximal myotonic myopathy (PROMM), a hereditary disorder, had predominantly proximal weakness, pain, and gait impairment aggravated by warm temperatures. EMG of the deltoid showed sparse abnormal spontaneous activity at room temperature and with cooling. Warming induced frequent myotonic discharges and fibrillations. Profuse myotonia recorded at room temperature in the first dorsal interosseous abated following cooling. Repetitive stimulation did not reveal a decrement recording from distal muscles, but recording from the deltoid, in the one patient tested, revealed a significant decrement that did not improve with edrophonium. Myopathic motor units were recorded only in distal musculature. The myotonia of PROMM is provoked by heat and diminished by cold and may have a different physiologic basis than traditional myotonic syndromes.

Electromyography↗
PubMed1989

Spinal dynorphin involvement in the analgesia of pregnancy: effects of intrathecal dynorphin antisera.

In both rats and humans there is an analgesia associated with pregnancy. This analgesia is spinally mediated and involves the kappa type of opiate receptor. The current study demonstrates that intrathecal administration of high affinity dynorphin antibodies produces a significant reduction in jump thresholds during pregnancy (day 20). The administration of pre-adsorbed antisera fails to produce this effect. These results support the hypothesis that a spinal dynorphin/kappa opiate receptor system is activated during gestation.

Analgesia↗
PubMed1988

Spinal kappa-opiate receptor involvement in the analgesia of pregnancy: effects of intrathecal nor-binaltorphimine, a kappa-selective antagonist.

In a variety of laboratory animals as well as humans, pregnancy has been associated with an activation of a maternal opioid system(s) and with a concomitant elevation in the threshold for maternal responsiveness to aversive stimuli. This analgesia is mediated via the activation of spinal opiate receptors and does not require an intact peripheral opioid system(s). The recently developed kappa-selective opioid antagonist, nor-binaltorphimine (nor-BNI), significantly reduces the threshold for reflexive jumping in response to electric foot shock when administered to the lumbar intrathecal (i.t.) space of pregnant rats (day 20 of gestation). In contrast, i.t. nor-BNI when administered to non-pregnant rats as well as systemic (i.p.) administration of an intrathecally effective dose of nor-BNI to pregnant rats is without effect on the jump thresholds. These data indicate that the kappa-type of opiate receptor mediates, at least in part, the analgesia observed during gestation, thus providing an important physiological function for this receptor type.

Analgesia↗