An examination of neurophysiologic features of median nerve in third trimester of regularly controlled normal risk pregnancies is performed at the Department of Neurophysiology of Primary Health Centre in Tuzla during January / April 2006. Examined group consisted of 40 young females in third trimester of pregnancy, and average age of 25,6 +/- 4,9 years. Control group consisted of young healthy females with average age of 31,1 +/- 4,4 years. Symptoms and signs of carpal tunnel sy. (CST) had 12 patients, but diagnosis is neurophysiologically confirmed in 9 (75%) patients. In group of pregnant females without symptoms 3 (10,7%) patients showed neurophysiologic evidence of CTS. Sensory velocity of right median nerve was significantly lower in pregnant group of patients (p=0,002), but area of sensory potentials on both sides were lower in pregnant group (p<0,0001). Area of CMAP of right median nerve was significantly lower in pregnant group (p=0,0003). Significant differences in CTS group compared with control group were in sensory velocities of median nerve (left median nerve p=0,0007, right p<0,0001), and area of SNAP of both sides (left p<0,0001, right p=0,0001), but area of CMAP right (p=0,0003). In CTS group 7 females had unilateral and 5 had bilateral neurophysiological changes. Our conclusion is that neurophysiological parameters of median nerve in third trimester of pregnancy are changed mainly due to high prevalence of CTS that might disturb quality of life and have psychological and physical implications on future mother. Hence, it is necessary to, continuously, pay enough attention in prevention or treatment of mentioned syndrome in this population group.
In this study we examined motor and sensory conduction velocities in right median and ulnar nerves in diabetic patients. Control group consisted of 25 healthy volunteers (13 males) with average age of 52 years. The first examined group consisted of 25 diabetic patients (13 males) without retinal changes, 59,6 years old on average, and the second group consisted of 40 patients (15 males) 59,4 years old on average: 22 of them with type 1, and 18 with type 2 retinal changes. The motor and sensory conduction velocities in right median nerve in the control group were significantly higher than those measured in the first group (p<0,0005 for motor, and p=0,0027 for sensory velocity), and the second group (p<0,0001 for motor, and p=0,0001 for sensory velocity). Significantly higher conduction velocities in sensory median nerve were compared between the examined groups (p<0,001), but motor conduction velocity was not significantly higher (p=0,09). The motor conduction velocity in ulnar nerve in the control group was significantly higher in comparison with the patients of first (p=0,0027) and second examined group (p=0,0001). The sensory conduction velocity in ulnar nerve was not significantly higher compared with the first (p=0,081), and significantly higher compared with the second examined group (p<0,0001). The sensory conduction velocity of ulnar nerve was significantly higher (p=0,019) in diabetic patients without retinopathy compared with patients with retinopathy. Diabetic patients with retinal changes have higher risk of developing more severe neurophysiologic signs of neuropathy. So, simple observation with ophthalmoscope may be useful diagnostic tool in its determination and may be the target of further therapeutic strategy.
Introduction: The aim of this study was to measure electroneurographic (ENG) parameters of the median and ulnar nerve in patients with metabolic syndrome and to determine whether the large imbalance in glycemic control came to neuropathic changes to the template.Methods: The study included 100 patients with metabolic syndrome diagnosed according to the criteria of the National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III). The patients were divided into two groups. Group I – patients with normal glycemic control and Group II - patients with diabetes mellitus for up to five years. We measured sensory conductive velocity (SCV), the amplitude of sensory nerve action potential (SNAP), motor conductive velocity (MCV), terminal motor latency (TML) and compose muscle action potential after distal stimulation (CMAP-I) and after proximal stimulation (CMAP-II) for the ulnar and median nerve.Results: Sensory and motor parameters in Group II were amended to neuropathic pattern compared to Group I. There were significant differences in: SNAP amplitude for all tested nerves, SCV values for both left and right median and ulnar nerve; MCV and TML for left median nerve; MCV, TML and CMAP-I for right median nerve area; MCV and TML for left ulnar nerve; MCV, CMAP-I and CMAP-II for right ulnar nerve area.Conclusion: Patients with metabolic syndrome and diabetes mellitus duration of five years have the significant changes in sensory and motor peripheral nerves. Neuropathic changes are possible in patients with metabolic syndrome and normal glycemic control.
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