DIAGNOSTICS OF NERVE IMPULSES TRANSMISSION PATHOLOGY IN PATIENTS WITH SUSPECTED THORACIC OUTLET SYNDROME USING CLINICAL NEUROPHYSIOLOGY TESTS
Autor: | Paulina Wietrzak, Anna Kalek, Agata Maria Kaczmarek, Juliusz Huber |
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Rok vydání: | 2021 |
Předmět: | |
Zdroj: | Issues of Rehabilitation, Orthopaedics, Neurophysiology and Sport Promotion – IRONS. 35:61-66 |
ISSN: | 2300-0767 |
DOI: | 10.19271/irons-000138-2021-35 |
Popis: | Introduction Thoracic Outlet Syndrome (TOS) is a group of conditions characterized by compression of the nerves, arteries and veins in the lower neck and upper chest area. On average, six physicians of different specialities need 4.3 years to develop TOS diagnosis. Early detection of changes in transmission of nerve impulses within the brachial plexus may lead to faster and more effective treatment of patients. Aim The aim of the study is to present the scheme of diagnostic tests of clinical neurophysiology contributing to the objective diagnosis of TOS, as well as the positive results of tests in a group of sixteen patients with clinically confirmed pathological symptoms. Material and methods Sixteen patients with clinically diagnosed TOS and sixteen healthy people as a control group aged from 18 to 36 participated in this study. In both groups of subjects, bilateral clinical neurophysiological diagnostics tests were carried out: an examination of the sensory perception with von Frey’s filaments within C4-C8 dermatomes, examination of surface electromyography (sEMG) during maximal contractions when recordings from proximal and distal muscles of the upper extremities were performed, the electroneurographic transmission of nerve impulses in selected nerves of the upper extremities (ENG) and motor evoked potentials recordings induced with the magnetic field (MEP) following oververtebral C5 and C6 stimulation. Results Comparing to studies performed in a control group of healthy volunteers, more than 50% of patients with clinical symptoms of TOS had confirmed abnormalities in the diagnostic tests of clinical neurophysiology, unilaterally or bilaterally. Conclusions In the diagnosis of TOS, sEMG recordings from the distal muscles of upper extremities during maximal contractions after induction of ischemia (“hand-raised test”), ENG segmental examination of nerve impulses transmission in motor fibers after stimulation of the median and ulnar nerves, and MEP examination after oververtebral C5 and C6 stimulation are particularly useful. Confirmation of a relatively high percentage of positive TOS tests in patients requires a greater number of neurophysiological examinations. Keywords: Thoracic Outlet Syndrome, neurophysiological diagnostics, motor evoked potentials |
Databáze: | OpenAIRE |
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