Semi-quantitative electromyography as a predictor of nerve transfer outcome.

Objectives: Evaluate correlation between donor nerve semi-quantitative electromyography (sqEMG) and strength outcome in nerve transfer surgery.

Methods: Retrospective review of pre-operative donor nerve semi-quantitative neurophysiology and post-operative recipient muscle force after at least one-year follow-up. The semi-quantitative technique is the average motor unit number estimate associated with needle recorded interference patterns in the donor muscle (IP-AMUNE), which was correlated with hand-held manometry, standardized as a percent of the contralateral arm, using multivariable linear regression with backward selection.

A neurophysiological approach to nerve transfer to restore upper limb function in cervical spinal cord injury.

A successful nerve transfer surgery can provide a wealth of benefits to a patient with cervical spinal cord injury. The process of surgical decision making ideally uses all pertinent information to produce the best functional outcome. Reliance on clinical examination and imaging studies alone can miss valuable information on the state of spinal cord health.

Anesthesia considerations for monitoring TCMEPs in adults diagnosed with poliomyelitis as children: a case report.

Unlabelled: The use of transcranial motor evoked potentials (TCMEPs) to detect and hopefully prevent injury to the brain, spinal cord, and peripheral nerves intraoperatively has increased greatly in recent years. It is well established that in addition to certain anesthetic agents, patient factors such as advanced age, obesity, diabetes, hypertension, and a collection of neurological and neuromuscular diseases and disorders can greatly reduce or completely eliminate the ability to monitor TCMEPs effectively. One such disease, poliomyelitis (polio), is a highly contagious viral disease that has been mostly forgotten since its near-eradication through vaccination.

The clinical practice of reconstructive neurosurgery.

Surgical interventions to improve function following nervous system injury have been in development since the early 1900s. Only recently these have been assimilated into a coherent approach which can be applied to injuries of the brain, spinal cord and peripheral nerves. In addition to pharmacological and stimulation based interventions, surgical manipulation of the peripheral nerves and muscles of the extremity can offer functional enhancement for a variety of limb impairments.

A self-referential outlier detection method for quantitative motor unit action potential analysis.

Quantitative MUAP analysis is often based on outlier detection, in the case of neurogenic conditions, the finding of MUAPs that are larger than the limit determined from a reference normal population. Such reference data is available from only a few sources and for only a few muscles. It would be desirable if muscles could serve as their own controls.

Quantification of motor unit action potential energy.

Objective: Motor unit action potentials (MUAPs) recorded by needle electrode reflect the functional state of the motor unit and its force-generating capacity, and are usually described morphologically (e.g. amplitude, duration).

Application of time-varying analysis to diagnostic needle electromyography.

Quantification in clinical, diagnostic electromyography (EMG) currently includes motor unit action potential (MUAP) analysis and interference pattern analysis. Early efforts to examine the frequency/power spectra of the interference pattern showed modest value but the technique was not developed further. This paper re-examines spectral analysis, extending it into the time-varying domain, which has never been studied in diagnostic needle EMG.

Efficacy and safety of botulinum type A toxin (Dysport) in cervical dystonia: results of the first US randomized, double-blind, placebo-controlled study.

Botulinum toxin type A (Dysport) has been shown in European studies to be a safe and effective treatment for cervical dystonia. This multicenter, double-blind, randomized, controlled trial assessed the safety and efficacy of Dysport in cervical dystonia patients in the United States. Eighty patients were randomly assigned to receive one treatment with Dysport (500 units) or placebo.