Concentric Needle Electromyography Findings in Patients with Ulnar Neuropathy at the Elbow.

In ulnar neuropathy at the elbow (UNE), the degree of neuropathic changes, the sensitivity of needle electromyography (EMG) in individual ulnar muscles, and the utility of individual EMG parameters are controversial. I compared qualitative needle EMG findings in two ulnar-innervated hands muscles and two ulnar-innervated forearm muscles in a group of previously reported UNE patients. Altogether, 170 UNE patients (175 arms) were studied.

Ultrasonographic abnormalities in clinically unaffected nerves of patients with nonvasculitic motor and sensorimotor mononeuropathies.

Introduction/aims: Diagnostic criteria for multifocal motor neuropathy (MMN) and multifocal acquired demyelinating sensorimotor neuropathy (MADSAM) require the involvement of at least two peripheral nerves. However, many patients with very similar features have clinical involvement of only a single peripheral nerve, which may preclude their correct diagnosis and treatment. The present study aimed to present a cohort of such patients and discuss the role of ultrasonography (US) in their diagnosis.

Differentiating viral and bacterial infections: A machine learning model based on routine blood test values.

The growing threat of antibiotic resistance necessitates accurate differentiation between bacterial and viral infections for proper antibiotic administration. In this study, a Virus vs. Bacteria machine learning model was developed to distinguish between these infection types using 16 routine blood test results, C-reactive protein concentration (CRP), biological sex, and age.

Clinical and neurophysiological recovery of ulnar nerve conduction block at the elbow.

Introduction/aims: An important mechanism of peripheral nerve motor and sensory dysfunction is conduction block (CB). However, recovery from mechanically induced CB has been rarely studied in humans. The aim of this study was to describe clinical, electrodiagnostic (EDx), and ultrasonographic (US) characteristics of CB recovery in ulnar neuropathy at the elbow (UNE).

No Major Nerve Regeneration Seems to Occur during Recovery of Ulnar Neuropathy at the Elbow.

There are three main potential mechanisms of recovery after nerve lesion: (1) resolution of conduction block, (2) collateral reinnervation, and (3) nerve regeneration. Their relative contributions in recovery after focal neuropathies are not well established. In a group of previously reported prospective cohort of patients with ulnar neuropathy at the elbow (UNE), I performed a post-hoc analysis of their clinical and electrodiagnostic findings.

Ultrasonography of peripheral nerve tumours: a case series.

Background: Peripheral nerve tumours (PNTs) are rare, but important cause of peripheral nerve dysfunction. The aim of the study was to present a series of consecutive patients with PNTs evaluated in authors' ultrasonography (US) practice.

Patients And Methods: The electronic medical records of patients with PNTs examined at our US laboratory from February 2013 to May 2020 were retrospectively reviewed.

Expert consensus on the combined investigation of carpal tunnel syndrome with electrodiagnostic tests and neuromuscular ultrasound.

Expert consensus was sought to guide clinicians on the use of electrodiagnostic tests (EDX) and neuromuscular ultrasound (NMUS) in the investigation of suspected carpal tunnel syndrome (CTS). Consensus was achieved using the Delphi method via three consecutive anonymised surveys of 15 experts and was defined as rating agreement ≥ 80%. The panel agreed that combining EDX and NMUS is more informative than using each modality alone.

Length of affected nerve segment in ulnar neuropathies at the elbow.

Objective: To establish length of the affected nerve segment (LANS) in ulnar neuropathy at the elbow (UNE).

Methods: In a group of our previously reported UNE patients we identified 2-cm segments with reduced motor nerve conduction velocity (MNCV) on electrodiagnostic (EDx) studies and increased nerve cross-sectional areas (CSA) on ultrasonographic (US) studies. LANS was obtained by summation of these abnormal 2-cm segments separately for each approach.

Expert consensus on the combined investigation of ulnar neuropathy at the elbow using electrodiagnostic tests and nerve ultrasound.

The addition of ultrasound (US) to electrodiagnostic (EDX) tests can significantly enhance the accuracy of testing for ulnar neuropathy at the elbow (UNE). We aimed to obtain expert consensus to guide clinicians on the combined use of EDX and US in UNE investigation. Consensus was achieved using the Delphi method.

COVID-19 diagnosis by routine blood tests using machine learning.

Physicians taking care of patients with COVID-19 have described different changes in routine blood parameters. However, these changes hinder them from performing COVID-19 diagnoses. We constructed a machine learning model for COVID-19 diagnosis that was based and cross-validated on the routine blood tests of 5333 patients with various bacterial and viral infections, and 160 COVID-19-positive patients.

Patterns and parameters describing nerve thickening in compression and entrapment ulnar neuropathies at the elbow.

Objective: To compare pattern and parameters describing nerve thickening in ulnar neuropathy at the elbow (UNE) due to external compression in the retrocondylar groove (RTC), and entrapment under the humeroulnar aponeurosis (HUA).

Methods: In a group of our previously reported UNE patients we ultrasonographically (US) measured ulnar nerve cross-sectional areas (CSA) on 6-8 standard locations in the elbow segment. We compared CSA patterns in both groups, and determined diagnostic utility of selected CSA based parameters.

Differentiation of ulnar neuropathy at the wrist due to ganglion cyst from ulnar neuropathy at the elbow.

Objective: Here, we aimed to describe the clinical, electrodiagnostic (EDx) and ultrasonographic (US) findings in a series of patients with ulnar neuropathy at the wrist (UNW) due to compression by a ganglion cyst. We also sought features that differentiate UNW from ulnar neuropathy at the elbow (UNE).

Methods: We reviewed electronic medical records of consecutive patients with UNW caused by ganglion cysts.

Utility of nerve conduction studies and ultrasonography in ulnar neuropathies at the elbow of different severity.

Objective: To report the sensitivity and the ability to precisely localize ulnar neuropathies at the elbow (UNE) of different severity by ultrasonography (US) and compare it to standard 10-cm nerve conduction studies (NCSs), and 2-cm short-segment NCSs (SSNCSs) across the elbow.

Methods: In a group of consecutive UNE patients, a prospective and blinded study was performed. The evaluation included clinical examination, electrodiagnostic (EDx) and US studies.

Contribution of ultrasonography in evaluating traumatic lesions of the peripheral nerves.

Objective: To assess the indications for and utility of diagnostic ultrasonography (US) in a series of consecutive patients with suspected traumatic peripheral nerve lesions (TPNL).

Methods: We retrospectively reviewed the electronic medical records of consecutive patients referred from February 2013 to May 2018 to our US laboratory. All included patients were examined using standard US equipment, with a 4-13MHz linear array transducer.

Validation of clinical criteria for referral to head imaging in the neurologic emergency setting.

Background: In recent decades, diagnostic imaging became an important generator of large increases in medical spending. Inappropriate head CT referrals also increase population irradiation and unnecessarily burden and frighten patients.

Objective: To validate previously proposed clinical criteria for referral to head imaging (age > 55 years, focal neurological deficit, changed mental state, nausea or vomiting, coagulation disorder, cancer) in a setting of emergency neurological service.

Standards for quantification of EMG and neurography.

This document is an update and extension of ICCN Standards published in 1999. It is the consensus of experts on the current status of EMG and Neurography methods. A panel of authors from different countries with different approach to routines in neurophysiological methods was chosen based on their particular interest and previous publications.

Neuropathic changes in the tongue protruder muscles in patients with snoring or obstructive sleep apnea.

Objective: Both myopathic and neuropathic tongue protruder muscle changes have been demonstrated to occur in obstructive sleep apnea (OSA) patients using different methods. We tried to elucidate this dilemma using quantitative electromyographic (EMG) methods.

Methods: In a group of consecutive patients with suspected OSA a full overnight polysomnography (PSG) and quantitative needle EMG of the tongue protruder, biceps brachii and vastus lateralis muscles were performed.

Anorectal Dysfunction in Presymptomatic Mutation Carriers and Patients with Huntington's Disease.

Background: Huntington's disease (HD) patients often report anorectal dysfunction; however, in HD research no detailed analysis of these complaints has been published.

Objective: To report anorectal dysfunction in a systematically studied cohort of HD subjects.

Methods: In 54 HD patients (24 men) and 10 presymptomatic HD mutation carriers (2 men) and in 99 controls (44 men) a history of anal incontinence and constipation was obtained and data was compared accordingly.

Long-term outcomes in patients with ulnar neuropathy at the elbow treated according to the presumed aetiology.

Objectives: Ulnar neuropathy at the elbow (UNE) consists mainly of two conditions: entrapment under the humeroulnar aponeurosis (HUA) and extrinsic compression in the retrocondylar (RTC) groove. These in our opinion need different treatment: surgical HUA release and avoidance of inappropriate arm positioning, respectively. We treated our UNE patients accordingly, and studied their long-term outcomes.

Contribution of ultrasonography to the evaluation of peripheral nerve disorders.

Objective: Although ultrasonographic (US) visualization of peripheral nerves is becoming more and more frequently used, there are few studies on its actual contribution to the diagnosis and management of patients with peripheral nerve disorders.

Methods: The electronic records of consecutive patients referred to our US laboratory over an eight-month period were retrospectively analyzed. The contribution of US examination to patient management was evaluated.