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Biomedical subjects

P Seror

Publications and source records attributed to P Seror.

At least 55 records · Page 3Linked to original sources
PubMed1994

Sensitivity of the various tests for the diagnosis of carpal tunnel syndrome.

The electrophysiological results of a prospective study of 150 successive cases of carpal tunnel syndrome in 96 patients are reported to evaluate the sensitivity of nine different electrophysiological tests and thresholds for the diagnosis of carpal tunnel syndrome. The distal motor latency was > 5 ms in 35% of cases and > or = 4 ms in 55% of cases. The distal sensory latency from the PIP joint of the middle finger was up to 3.4 ms in 61% of cases. The middle finger orthodromic conduction velocity (14 cm) was < or = 45 m/s in 66% of cases and the orthodromic conduction velocity after palmar stimulation (8 cm) was < or = 45 m/s in 76%. The remaining 24% of cases were assessed by special tests such as specific median-ulnar latency difference (21%), and the centimetric test was altered in all. Highly sensitive tests are required to assess or exclude the diagnosis in one quarter of cases of carpal tunnel syndrome. Although the specific median-ulnar latency difference is the easiest test to perform, the centimetric test is the most valuable for the assessment of the mildest forms of carpal tunnel syndrome.

Carpal Tunnel Syndrome↗
PubMed1994

[Study of the proximal conduction of the arms using SEP and MEP].

The proximal conduction of the upper limb has been studied with the somatosensory evoked potentials (SEP) and motor evoked potentials (MEP) in 40 controls which provided normal data. The SEP allowed the sensory conduction study of the Erb/C7 segment with N9/N13 delay determination after the median nerve stimulation at the wrist, and after the ulnar nerve stimulation at the wrist (20 cases) or above the elbow (20 cases). The N9/N13 delay was 3.24 ms +/- 0.35 for the median nerve, 3.30 ms +/- 0.52 for the ulnar nerve after stimulation at the wrist and 3.30 ms +/- 0.40 after stimulation at the elbow. The Erb point potential amplitude after ulnar nerve stimulation at the elbow was always greater than after the median nerve stimulation at the wrist: 13.2 microV versus 8.8 microV. The MEP allowed the C6/axilla motor conduction study. The recording was performed on the adductor digiti quinti. The proximal motor conduction velocity was 74 m/s +/- 8 (mini 60). The conduction delay was then 3.02 ms +/- 0.3. A constant amplitude loss was observed between the axilla and the cervical spine; it was never greater than 30% in controls. Allthings considered both methods provided very complementary data on the proximal nerve conduction of the upper limb at the brachial plexus. The conduction delay in the brachial plexus was around 3 ms and was very similar to the distal motor and sensory latencies of the median nerve at the wrist. Motor conduction blocks of more than 30% and 1 ms increament of the conduction delay were regarded as pathological.

Adult↗
PubMed1994

[Nocturnal orthosis: a new treatment of compression of the ulnar nerve at the elbow. 30 cases].

Compression of the ulnar nerve at the elbow was confirmed by electromyography in 30 patients including 29 cases of idiopathic aetiology and 1 case of late onset ulnar palsy. Six cases occurred after general anaesthesia and 3 had undergone an unsuccessful operation. All patients were managed solely with an orthesis worn at night. The orthesis held the elbow in 60 degrees flexion. Clinical improvement was noted in all cases (including the 3 cases of unsuccessful surgery) evaluated by the patient and the physician at 88% on the average. Improvement occurred rapidly and was evaluated at 50% on day 15 in 9 out of 10 patients seen on this day. The level of improvement was directly related to regular use of the orthesis. Seven electromyographic criteria were measured and nerve conduction speed was 33.0 m/sec (motor and sensory) and improved significantly by 7.3 m/sec (motor) and 9.5 m/sec (sensory) in all cases but one (p < 10(-8)). In conclusion, this simple non-invasive management protocol is not a simple symptomatic treatment but helps restore nerve function. The effectiveness of this method suggests that nocturnal position plays a major role in impairment due to compression of the ulnar nerve.

Adult↗
PubMed1993

Forearm pain secondary to compression of the medial antebrachial cutaneous nerve at the elbow.

We report the case of a 42-year-old man whose only symptom was pain in the medial aspect of the left forearm. There were no paresthesiae and the clinical examination was normal except for the presence of a small lipoma at the elbow. Electromyographic examination confirmed the normality of the main nerve trunks of the left upper limb and demonstrated abnormalities of the left medial antebrachial cutaneous nerve when compared with the right side. On the basis of this finding, a local corticosteroid injection was performed, which rapidly and lastingly relieved the pain (no recurrence after 18 months).

Action Potentials↗
PubMed1993

Relative frequency of nerve conduction abnormalities at carpal tunnel and cubital tunnel in France and the United States: importance of silent neuropathies and role of ulnar neuropathy after unsuccessful carpal tunnel syndrome release.

The two most frequently diagnosed nerve compression syndromes of the upper extremities are carpal tunnel syndrome and cubital tunnel syndrome. In order to determine the relative frequencies of nerve conduction abnormalities at the carpal tunnel and cubital tunnel in France and the United States, we evaluated all patients (nFR = 882 and nUS = 818) who had nerve conduction studies of the upper extremities over a six-yearFR or three-yearUS interval. In both France and the United States, the risk of electrophysiological abnormalities was 2 to 1 for the wrist relative to the elbow. Abnormal median nerves were twice as likely to be symptomatic as were abnormal ulnar nerves (silent ulnar neuropathy). Thus, the clinical risk for carpal tunnel syndrome relative to cubital tunnel syndrome was approximately 4 to 1. In many cases of persistent hand symptoms following carpal tunnel release, the problem may actually be related to an undiagnosed ulnar nerve lesion. Thus, a complete neurophysiological evaluation of the upper extremity necessitates both median and ulnar studies.

Adolescent↗
PubMed1993

Treatment of ulnar nerve palsy at the elbow with a night splint.

Twenty-two patients with ulnar nerve palsy at the elbow, confirmed by electromyography, were treated by a night splint which prevented flexion of the elbow beyond 60 degrees. The splint was worn all night regularly for at least six months. At a mean follow-up of 11.3 months, 17 patients had clinical and electromyographic assessment and five were contacted by telephone. There was improvement in the symptoms in every patient, including three who had failed to respond to surgical decompression. There was electromyographic improvement in 16 of the 17 patients re-examined at follow-up. The mean improvement in motor nerve conduction velocity was 6.5 m/s and in sensory nerve conduction velocity 9.5 m/s. The efficacy of this treatment suggests that nocturnal elbow flexion is an important cause of ulnar nerve lesions at the elbow.

Adult↗
PubMed1992

Nerve conduction studies after treatment for carpal tunnel syndrome.

125 cases of carpal tunnel syndrome confirmed electrophysiologically were the subject of longitudinal nerve conduction studies to assess spontaneous improvement and effect of treatment. 36 cases showed a slowly progressive deterioration which became statistically significant only on lengthy follow-up; analysis of interval tests in these cases revealed that definite improvement or rapid worsening can occur in the interim. The 56 cases studied after local corticosteroid injections showed a statistically significant improvement at one month followed by an overall progressive return to the previous abnormal values in six to 12 months, indicating only slight and temporary alteration in the natural progression of the conduction deficit. The 33 cases which underwent surgical release of the median nerve were shown to have obvious and often rapid improvement, which was sustained for at least one year after surgery.

Adrenal Cortex Hormones↗
PubMed1992

[Ulnar nerve lesion at the elbow. Epidemiological, clinical and electromyographical data. Apropos of 312 patients].

Four hundred and ninety-three electromyographic ulnar nerve lesions identified in 312 patients were reviewed. During the same period, 1,000 cases of median nerve entrapment were seen in the same department. Among ulnar nerve lesions, 84% were idiopathic and only 52% were responsible for clinical symptoms. In patients with symptoms, three main patterns of paresthesia were seen: exacerbation at night and/or in the morning upon awakening (39%), permanent isolated paresthesia (34%), and permanent paresthesia with exacerbation at night and/or in the morning upon awakening (27%). Objective sensory loss was found in 1/3 to 1/4 of cases. All patients with muscle wasting (11%) also had sensory loss; muscle strength was markedly decreased in 19% of patients. Pain was mild and infrequent (35%). Electromyographic studies revealed a decrease in motor and sensory conduction velocity at the elbow (mean value 36.2 m/sec). Sensory conduction velocity was the most sensitive parameter for detecting incipient or moderate forms, whereas motor conduction velocity was extremely helpful in severe forms. Eighty-three per cent of patients had alterations of both conduction velocities (sensory and motor). In the mildest forms, nerve conduction velocity was normal (13% of cases); in these patients diagnosis was established on the basis of either a partial motor conduction block (3%) or desynchronization of the sensory action potential (10%).

Elbow↗
PubMed1991

Carpal tunnel syndrome in the elderly. "Beware of severe cases".

This study compares the clinical and electrophysiological features of Carpal Tunnel Syndrome (CTS) in elderly (over 70 years of age) and middle age populations (50-60 years of age). Our study shows a severe (95%) electrophysiological motor and sensory denervation of CTS, in 60% of the elderly group and only 18% of the middle aged group (P much much less than 10(-3). Clinically, the presence of thenar wasting was the only reliable sign of significant denervation, Phalen's test, Tinel sign and painful paresthesia being equivocal. Some 18% of the elderly were asymptomatic despite 25% of these patients having severe neurological impairment. It was noted that exclusively diurnal paresthesiae were confined to the elderly group (23%) (P much less than 10(-3)). To avoid permanent disability the elderly should be viewed as a high risk group of severe cases even in the absence of firm clinical evidence and should undergo objective electrophysiological assessment with a view to surgical intervention as a priority.

Aged↗