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The efficacy of electrotherapeutic procedures in cases of nerve conduction abnormalities demonstrated in motor fibres of the facial nerve by neurophysiological studies

100%

Zagłoba A., Huber J., Witkowska A., Lisiński P., Warzecha D.

Medical Rehabilitation

2008

vol. 12(4)

10-22

Wstęp: Celem pracy jest przedstawienie wyników kompleksowych badan z zakresu elektromiografii globalnej (EMG) oraz elektroneurografii (ENG, badanie fali M) włókien ruchowych nerwu twarzowego u 25 chorych z objawami obwodowego pora8enia nerwu twarzowego oraz algorytmu usprawniania tych chorych za pomocą zabiegów fizykoterapeutycznych (elektroterapia włókien ruchopalwych nerwu twarzowego) wspomaganych równie8 ukierunkowana kinezyterapia. W tych przypadkach wczesna i obiektywna diagnostyka, jak i natychmiastowe wdrożenie leczenia, pozwalają na uzyskanie szybszej poprawy funkcji ruchowej mięśni twarzy. Metoda: Testy diagnostyki neurofizjologicznej objęły obustronne badania elektromiografii globalnej wybranych mięśni twarzy (EMG; m. czołowy, m. dźwigacz skrzydła nosa, m. okre8ny ust) oraz badania elektroneurograficzne przewodnictwa eferentnego nerwu twarzowego (ENG, fala M). Na podstawie diagnozy lekarza prowadzącego, badanych chorych (n=25) podzielono ze względu na przyczynę porażenia: stan zapalny (n=8), rekonstrukcja chirurgiczna (n=7), idiopatyczne pora8enie typu Bella (n=10). Analogicznymi badaniami objęto grupę 25 zdrowych ochotników. Na ich podstawie stworzono wzorzec prawidłowych parametrów badan EMG i ENG nerwu twarzowego dla osób, u których nie stwierdza się żadnych zaburzeń ze strony układów nerwowego i mięśniowego. W wyniku prowadzonych powtarzalnych testów neurofizjologii klinicznej, ustalone zostały odpowiednie, indywidualne dla ka8dego chorego parametry elektrostymulacji, monitorowane po 10 i po 20 zabiegach fizjoterapeutycznych. Wyniki i wnioski: Badania neurofizjologiczne po dwóch etapach leczenia wykazały poprawę sprawności jednostek ruchowych badanych mięśni twarzy oraz przewodnictwa włókien ruchowych nerwu twarzowego. Otrzymane porównawczo wyniki badan EMG i ENG poprzez analizę parametrów częstotliwości rekrutacji jednostek ruchowych oraz nate8enia prądu stosowanego do wywołania fali M pozwoliły na określenie optymalnych parametrów elektrostymulacyjnych nerwu twarzowego. Kompleksowe badania neurofizjologiczne pozwalają na oszacowanie postępów leczenia zachowawczego oraz ukierunkowanie zabiegów fizykoterapii prowadzącej do wyraźnej poprawy czynności rehabilitowanych mięśni twarzy.

Aim: The aim of the study was to show the results of complex electromyography (global EMG) and electroneurographic (ENG, M wave) studies of motor fibres of the facial nerves in 25 patients with symptoms of peripheral facial nerve palsy as well as to evaluate a therapeutic algorithm involving therapy with physical agents (electrotherapy of motor fibres in the facial nerve) supplemented with focused kinesitherapy. In such cases, early and objective diagnosis and immediate introduction of treatment allow one to obtain better results in the motor function of the face muscles.Method: Neurophysiological tests included bilateral recordings of global electromyography from selected facial muscles (EMG; the frontal muscle, the levator alae nasi muscle, the orbicularis oris muscle) and electroneurographic motor conduction studies (ENG, M wave). Based on the diagnosis established in the treated patients (n=25) by the attending physician, the patients were divided into three groups, depending on the cause of palsy: inflammation (n=8), surgical reconstruction (n=7), idiopathic Bell’s palsy (n=10). Twenty-five healthy volunteers were studied using similar methods for comparison. Results from these studies in persons without any disturbances of the muscle-skeletal system served as a pattern of normal parameters in EMG and ENG studies. Repeated clinical neurophysiologic tests were fundamental for ascertaining the parameters of electrostimulation patterns determined individually for each patient and they were monitored after 10 and 20 physiotherapeutic procedures.Results and conclusions: Neurophysiological examinations following two phases of treatment showed an improvement in the motor units activity of the facial muscles and in motor nerve transmission. The obtained results from EMG and ENG examinations, in particular the analysis of frequency parameters in recruitment of the muscle motor units and applied current intensity to evoke the M wave allowed us to determine optimal parameters for facial nerve stimulation. Complex neurophysiological studies enable an estimation of the progress of conservative treatment and allow one to direct therapy with physical agents towards better improvement in the activity o rehabilitated facial muscles.

Changes in Transmission of Lower Limbs Nerves After Varicose Veins Operations with Saphenous Vein Stripping

73%

Oszkinis G., Jaworucka-Kaczorowska A., Huber J., Kaczorowski P., Wiertel-Krawczuk A., Pukacki F., Zieliński M., Snoch M., Majewski W.

Polish Journal of Surgery

2008

vol. 80

issue 8

404-412

The injury of the lower limb nerves is a very frequent complication after the varicose veins surgical treatment. The stripping of the great saphenous vein can cause the lesion of saphenous nerve and other lower limb nervesThe aim of the study was to establish the relationship between the percentage of the nerve injuries at the long stripping of great saphenous vein and to estimate the impact of this surgical treatment on the quality of patient's life.Material and methods. The neurophysiological examinations which included 80 patients were performed four times- before the operation, 2 weeks, 3 and 6 months after the operation. The following neurophysiological examinations were used: the sensory conduction velocity studies (SCV), the intensity of current-stimulus duration curves (IC-SD) and the von Frey filaments examination, the electroneurography (ENG, M-wave studies) and electromyography (EMG). The questionnaire to estimate the quality of life among the patients after the varicose veins operations was also conducted.Results. 30 patients (36%) were found to be injured with the saphenous nerve. These disorders persisted among 17 patients (21.25%) 3 months and among 11 patients (13.75%) 6 moths after the operation. In 38 patient (47.5%) 2 weeks after the operation, 24 of patients (30%) 3 months after the operation and in 15 patients (18.75%) 6 months after the operation showed the abnormalities which were usually located near the medial ankle. The paraesthesia which occured among 32 patients (40%) did not worsen the quality of life and only one patient wouldn't agree to repeated operation. In 6 patients (7.5%) there was found hyperaesthesia which had the significantly bad impact on patient's life and 5 of them (83.33%) wouldn't agree to such an operation once again. There were also observed the temporary disorders of the tibial nerve (7 patients - 8.75%) and the peroneal nerve (17 patients - 21.25%).Conclusions. The varicose veins operations have the significantly bad influence on the saphenous nerve transmission and can cause a transient injury of the tibial and peroneal nerves. The sensory disorders usually concern the region of the medial ankle. The operation doesn't significantly worsen the patient's quality of life but the sort of sensory disorders has the influence on patient's estimation.

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1 Medical Rehabilitation

1 Polish Journal of Surgery

2 2008

2 Huber J.

1 Jaworucka-Kaczorowska A.

1 Kaczorowski P.

1 Lisiński P.

1 Majewski W.

1 Oszkinis G.

1 Pukacki F.

1 Snoch M.

1 Warzecha D.

1 Wiertel-Krawczuk A.

1 Witkowska A.

1 Zagłoba A.

1 Zieliński M.

Search results

The efficacy of electrotherapeutic procedures in cases of nerve conduction abnormalities demonstrated in motor fibres of the facial nerve by neurophysiological studies

Changes in Transmission of Lower Limbs Nerves After Varicose Veins Operations with Saphenous Vein Stripping