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1.
Front Neurol ; 15: 1402569, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38938785

RESUMO

Migraine, a prevalent neurological disorder, affects approximately 14.1% of the global population and disproportionately impacts females. This debilitating condition significantly compromises quality of life, productivity, and incurs high healthcare costs, presenting a challenge not only to individuals but to societal structures as a whole. Despite advances in our understanding of migraine pathophysiology, treatment options remain limited, necessitating ongoing research into effective therapies. This review delves into the complexity of migraine management, examining the roles of genetic predisposition, environmental influences, personalized treatment approaches, comorbidities, efficacy and safety of existing acute and preventive treatments. It further explores the continuum between migraine and tension-type headaches and discusses the intricacies of treating various migraine subtypes, including those with and without aura. We emphasize the recent paradigm shift toward trigeminovascular activation and the release of vasoactive substances, such as calcitonin gene-related peptide (CGRP), which offer novel therapeutic targets. We assess groundbreaking clinical trials, pharmacokinetic and pharmacodynamic perspectives, safety, tolerability, and the real-world application of CGRP monoclonal antibodies and gepants. In the face of persisting treatment barriers such as misdiagnosis, medication overuse headaches, and limited access to specialist care, we discuss innovative CGRP-targeted strategies, the high cost and scarcity of long-term efficacy data, and suggest comprehensive solutions tailored to Turkiye and developing countries. The review offers strategic recommendations including the formulation of primary care guidelines, establishment of specialized outpatient clinics, updating physicians on novel treatments, enhancing global accessibility to advanced therapies, and fostering patient education. Emphasizing the importance of lifestyle modifications and holistic approaches, the review underscores the potential of mass media and patient groups in disseminating critical health information and shaping the future of migraine management.

2.
Cephalalgia ; 29(1): 68-75, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18771489

RESUMO

Migraine is more likely to be misdiagnosed in patients with comorbid diseases. Not only primary care physicians, but also specialists might misdiagnose it due to the lack of diagnostic criteria awareness. The ID migraine test is a reliable screening instrument that may facilitate and accelerate migraine recognition. This study aimed to compare the prevalence and characteristics of migraine in a large sample of patients admitted to clinics of ophthalmology (OC), ear, nose and throat diseases (ENTC) and neurology (NC), as well as to validate the use of the ID migraine test in OC and ENTC settings. This was a multicentre (11 cites) study of out-patients admitting either to NC, ENTC or OC of the study sites during five consecutive working days within 1 week. From each of the clinics, 100 patients were planned to be recruited. All recruited patients were interviewed and those having a headache complaint received an ID migraine test and were examined for headache diagnosis by a neurologist, blinded to the ID migraine test result. A total of 2625 subjects were recruited. Only 1.3% of OC patients and 5.4% of ENTC patients have been admitted with a primary complaint of headache, whereas the percentage of NC patients suffering from headache was 37.6%. Whereas 138 patients (19.3%) in OC, 154 (17.3%) in ENTC and 347 (34%) in NC were found to be ID migraine test positive, 149 patients (20.8%) in OC, 142 (16%) in ENTC and 338 (33.1%) in NC were diagnosed with migraine. The sensitivity, specificity, and positive and negative predictive ratios of the ID migraine test were found to be similar in all clinics. An important fraction of the patients admitted to NC, as well as to OC and ENTC, for headache and/or other complaints were found out to have migraine by means of a simple screening test. This study validated the ID migraine test as a sensitive and specific tool in OC and ENTC, encouraging its use as a screening instrument.


Assuntos
Instituições de Assistência Ambulatorial/estatística & dados numéricos , Transtornos de Enxaqueca/diagnóstico , Transtornos de Enxaqueca/epidemiologia , Neurologia/estatística & dados numéricos , Oftalmologia/estatística & dados numéricos , Otolaringologia/estatística & dados numéricos , Adulto , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Prevalência
3.
Cephalalgia ; 27(12): 1323-38, 2007 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-17970766

RESUMO

Neurophysiological testing has become a valuable tool for investigating brain excitability and nociceptive systems in headache disorders. Previous reviews have suggested that most neurophysiological tests have limited value for headache diagnosis, but a vast potential for exploring the pathophysiology of headaches, the central effects of certain pharmacological treatments and phenotype-genotype correlations. Many protocols, however, lack standardization. This meta-analytical review of neurophysiological methods in migraine was initiated by a task force within the EUROHEAD project (EU Strep LSHM-CT-2004-5044837-Workpackage 9). Most of the neurophysiological approaches that have been used in headache patients are reviewed, i.e. evoked potentials, nociception-specific blink reflex, single-fibre electromyography, neuroimaging methods (functional MRI, PET, and voxel-based morphometry) and the nitroglycerin attack-provoking test. For each of them, we summarize the results, analyse the methodological limitations and propose recommendations for improved methodology and standardization of research protocols. The first part is devoted to electrophysiological methods, the second to neuroimaging techniques and the NTG test.


Assuntos
Eletrodiagnóstico/métodos , Eletrofisiologia/métodos , Transtornos de Enxaqueca/diagnóstico , Neurofisiologia/métodos , Garantia da Qualidade dos Cuidados de Saúde/métodos , Humanos , Itália , Guias de Prática Clínica como Assunto , Reprodutibilidade dos Testes , Sensibilidade e Especificidade
4.
Pain ; 75(2-3): 257-9, 1998 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-9583761

RESUMO

Levodopa has been used to treat some painful conditions and found to be effective in neuropathic pain due to herpes zoster in a double-blind study. From our anecdotal observations about the efficacy of levodopa on diabetic neuropathic pain, we designed a double-blind placebo-controlled study to test levodopa in painful diabetic neuropathy. Twenty-five out-patients with painful symmetrical diabetic polyneuropathy were admitted to the study. Fourteen patients were given 100 mg levodopa plus 25 mg benserazide to be taken three times per day for 28 days. Eleven patients were given identical placebo capsules. A blinded neurologist evaluated the patients clinically and performed Visual Analogue Scale (VAS) measurement every week from day 0 to day 28. The results seemed promising and levodopa may be a choice for the control of pain in neuropathy for which we do not have many alternative treatments.


Assuntos
Neuropatias Diabéticas/tratamento farmacológico , Neuropatias Diabéticas/fisiopatologia , Dopaminérgicos/uso terapêutico , Levodopa/uso terapêutico , Cuidados Paliativos , Doenças do Sistema Nervoso Periférico/tratamento farmacológico , Doenças do Sistema Nervoso Periférico/fisiopatologia , Adulto , Idoso , Benserazida/uso terapêutico , Método Duplo-Cego , Combinação de Medicamentos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor
5.
Spine (Phila Pa 1976) ; 23(9): 1016-22, 1998 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-9589540

RESUMO

STUDY DESIGN: This prospective study includes normal control subjects and patients with focal lesions of the spinal cord investigated by transcranial magnetic stimulation. OBJECTIVES: To establish a stable method to elicit motor evoked potentials from cervical to lumbar segmental levels and to apply the method that would allow the localization in patients with restricted cord lesion. Thirty-four healthy subjects (10 women, 24 men) and 17 patients with focal spinal lesions were admitted to this study. SUMMARY OF BACKGROUND DATA: The focal cord lesions and injuries were previously evaluated by the records of lower limb muscles after cortical stimulation, but this method did not demonstrate the vertebral levels at which the lesions were located. METHODS: The paravertebral myotomal-evoked potentials were recorded in different segmental levels (T1, T6, T12, and L3) from paravertebral muscles, using surface and needle electrodes by transcranial magnetic stimulation in normal control subjects and patients. RESULTS: In normal control subjects, paravertebral myotomal-evoked potentials were obtained from T1, T6, T12, and L3 paravertebral muscles with both recording techniques (surface and needle electrode). From T1 to L3 latencies of paravertebral myotomal-evoked potentials increased gradually (from 10 msec to 17 msec) in normal control subjects. The levels of spinal cord lesions were obtained reliably in 14 of 17 patients with thoracic-lumbar spinal cord lesions, by using both electrophysiologic methods. In 11 of 14 patients, the lesions produced total conduction block, at and below the lesion level. In the remaining 3 patients slowing of intersegmental conduction was observed along the focal cord lesion. CONCLUSIONS: The paravertebral myotomal-evoked potentials obtained by surface electrode from paravertebral muscles and by midline needle electrode in the intrinsic rotatory muscles of the spine were useful in localizing lesions in the spinal segments in most of the patients with thoracic-lumbar cord lesions.


Assuntos
Potencial Evocado Motor , Músculo Esquelético/fisiopatologia , Doenças da Medula Espinal/fisiopatologia , Adulto , Idoso , Vértebras Cervicais , Eletromiografia/métodos , Potencial Evocado Motor/fisiologia , Feminino , Humanos , Vértebras Lombares , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiologia , Estudos Prospectivos , Medula Espinal/fisiologia , Doenças da Medula Espinal/diagnóstico , Vértebras Torácicas
6.
Clin Neurol Neurosurg ; 96(2): 124-9, 1994 May.
Artigo em Inglês | MEDLINE | ID: mdl-7924074

RESUMO

Electrical stimulation (ES) of lumbosacral nerve roots using a needle electrode inserted to the laminar level at the midline of Th12-L1 or L1-2 intervertebral interspace, was compared with magnetic stimulation using a 9-cm diameter coil (MCS) at the L3-4 or L4-5 spine levels, Compound muscle action potentials (CMAP) were superficially recorded from homologous muscles in both sides in 15 normal control subjects and in 20 patients with lumbosacral radiculopathy. Soleus muscles were used for S1, tibialis anterior (TA) for L5, and rectus femoris (RF) muscles for L4 roots. According to the clinical or radiological diagnosis (CAT, MRI and/or myelography) conventional needle EMG was capable to localise the root lesion in 16 of 20 patients (80%) and ES localised the root involvement in 18 of 20 patients (90%); the diagnostic value of MCS was lower, about 65% (13 of 20 patients). Although ES is uncomfortable and invasive, it is superior to needle EMG in localising unilateral or multiple lumbosacral root involvement. At present, MCS is not suitable for the diagnosis of lumbar radiculopathy.


Assuntos
Estimulação Elétrica/instrumentação , Campos Eletromagnéticos , Doenças do Sistema Nervoso Periférico/diagnóstico , Raízes Nervosas Espinhais/fisiopatologia , Adulto , Idoso , Eletromiografia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculos/inervação , Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/fisiopatologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Tempo de Reação/fisiologia , Reflexo Anormal/fisiologia , Ciática/diagnóstico , Ciática/fisiopatologia
7.
Forensic Sci Int ; 116(2-3): 125-32, 2001 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-11182263

RESUMO

The estimation of postmortem interval is of great importance in forensic medicine. Changes in the properties of excitable tissue provide another possible means by which the time of death can be estimated. This paper reports the monitorization of the compound action potentials recorded from gastrocnemius muscle by means of sciatic nerve stimulation in rats before and after death. The sciatic nerve was stimulated using rectangular impulses of 0.1ms duration and intensities ranged between 1 and 100mA while the rat was alive. Subsequently, the rat was killed by cervical dislocation. The similar measurement procedure was performed at the moment of death and every 5min after sequentially. There was a progressive decline in amplitude values that began 10min after death. The decrease in the amplitude of the compound muscle action potentials (CMAP) was most prominent especially when elicited with lower stimulus intensities. The mean area of the CMAPs also began to decrease beginning from 15min after death. Fifteen minutes after death, the motor latencies began to prolong. Thirty-five minutes after death, the decline in amplitude and area of mean CMAP was most prominent as the mean motor latency. At the 40th minute, most of the CMAPs were unelicitable. During the early postmortem interval, these amplitude, area and motor latency alterations decrease in the amplitude and area, prolongation of motor latency seems to be well correlated with each other and this was statistically significant. These findings are discussed as possible basis of a forensic method for postmortem interval estimation.


Assuntos
Potenciais de Ação/fisiologia , Autopsia/métodos , Eletromiografia/métodos , Modelos Animais , Monitorização Fisiológica/métodos , Músculo Esquelético/fisiologia , Mudanças Depois da Morte , Animais , Autopsia/normas , Eletromiografia/normas , Masculino , Monitorização Fisiológica/normas , Ratos , Ratos Wistar , Tempo de Reação , Fatores de Tempo
8.
Electromyogr Clin Neurophysiol ; 35(5): 259-71, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-7498070

RESUMO

Lumbosacral root potentials and sacral spinal cord segmental responses were recorded epidurally in 24 normal adult subjects by tapping the Achilles Tendon with the electronic hammer (mechanical). The averaged responses were also recorded from the same epidural levels after the electrical stimulation of the Posterior Tibial nerve at the popliteal fossa (electrical). While the dorsal and reflexively evoked ventral root responses were easily obtained by the electrical stimulation; by the mechanical stimulation only a late and small ventral root response with two negative deflections could be evoked at the L4-5 or L5-S1 I.V. (intervertebral) epidural levels. The ventral root responses elicited by mechanical stimulation appeared 4.0 msec later than those elicited by the electrical stimulation. This time interval was exactly the same when the latencies of the Soleus reflexes to both stimuli were compared that for the Achilles tendon reflex being 4.0 msec delayed. When the sums of their afferent and the efferent conduction times (to and from Th12-L1 I.V. levels) were extracted from the total conduction times of the Soleus H and Achilles tendon reflex obtained by the EMG recordings, the sacral cord conduction delay was found 1.8 msec for the H-Reflex and 4.1 msec for the Achilles tendon reflex. It was suggested that the twice longer time delay along the sacral cord to Achilles tendon tap might be due to the oligosynaptic linkage of the Achilles tendon reflex or it may result from highly dispersed afferent volley producing a slowly rising wave or excitation that takes longer to reach threshold for the soleus motoneurone discharges.


Assuntos
Tendão do Calcâneo/inervação , Medula Espinal/fisiopatologia , Raízes Nervosas Espinhais/fisiopatologia , Adolescente , Adulto , Vias Aferentes/fisiopatologia , Vias Eferentes/fisiopatologia , Eletromiografia , Feminino , Reflexo H/fisiologia , Humanos , Dor Lombar/fisiopatologia , Masculino , Pessoa de Meia-Idade , Estimulação Física , Tempo de Reação/fisiologia , Valores de Referência , Ciática/fisiopatologia , Transmissão Sináptica/fisiologia , Nervo Tibial/fisiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-12613139

RESUMO

OBJECTIVES: To determine a new artifact discharge produced from the disposable concentric needle (DCN) electromyography (EMG) electrodes. METHODS: We have recorded the activity obtained after the first insertion of 41 DCN (37 mm) and 36 DCN (50 mm) in several muscles during the rest. The number of the patients was 77 (26 males, 51 female). RESULTS: We observed an artifact discharge (AD) resembling positive sharp waves (PSWs) in 31 patients of 77 insertions. The AD occurred with 18 of 41 insertions of DCN 37 mm and 13 of DCN 50 mm. The artifact resolved when the needle has been moved in the muscle or in the adipose subcutaneous tissue. CONCLUSION: This AD should be recognized when using DCN electrodes to avoid confusion with PSWs. Recognizing these artifacts during needle EMG is important to avoid false positive results.


Assuntos
Artefatos , Equipamentos Descartáveis , Eletrodos , Eletromiografia , Agulhas , Doenças Neuromusculares/fisiopatologia , Adolescente , Adulto , Diagnóstico Diferencial , Falha de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Músculo Esquelético/fisiopatologia
10.
Electromyogr Clin Neurophysiol ; 41(5): 273-9, 2001.
Artigo em Inglês | MEDLINE | ID: mdl-11572188

RESUMO

F tacheodispersion and some F wave parameters have previously been suggested to be useful in the detection of peripheral nerve involvement in diabetic patients with normal nerve conduction studies. In this study, ulnar and tibial F wave parameters of diabetic cases with normal motor and sensory nerve conduction studies (Group 1) were calculated, F tacheodispersion histograms were constructed and compared with the same parameters obtained from the normal controls (Control group) and diabetic cases with abnormal motor and sensory nerve conduction examinations (Group 2). There was a tendency towards lower conduction velocities in ulnar and tibial tacheodispersion histograms of Group 1 and Group 2, as compared to Control group. Most of the F wave values were significantly abnormal in Group 2 in comparison to other two groups, whereas statistically significant differences between Group 1 cases and Control group were found in minimum ulnar F wave conduction velocity (FCVmin), mean ulnar FCV (FCVmean), tibial FCVmin and tibial FCVmean values. Unlike other methods, F waves give information about the entire length of the motor nerve fiber. In mild neuropathies, in which nerve fibers are damaged uniformly, testing the whole length of a nerve with this method may be beneficial in detection of a mild conduction abnormality.


Assuntos
Neuropatias Diabéticas/diagnóstico , Eletromiografia , Adulto , Neuropatias Diabéticas/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neurônios Motores/fisiologia , Condução Nervosa/fisiologia , Tempo de Reação/fisiologia , Valores de Referência , Sensibilidade e Especificidade , Células Receptoras Sensoriais/fisiologia , Nervo Tibial/fisiopatologia , Nervo Ulnar/fisiopatologia
11.
Eur J Drug Metab Pharmacokinet ; 19(4): 319-25, 1994.
Artigo em Inglês | MEDLINE | ID: mdl-7737233

RESUMO

The relative bioavailability of three carbamazepine generics available in Turkey, were investigated in 5 healthy male volunteers. When issuing a license to any drug, FDA stipulates at most a difference of 20% from the reference drug only in peak concentration and AUC (area under the curve). This condition may cause some problems, as two generics of the same drug can yield the same total amount (AUC) and can be accepted as bioequivalent despite different curves of the two drugs. In this study, to compare drugs from the point of view of bioequivalency, we suggest a new calculation method that takes into account ka (absorption rate constant), ke (elimination rate constant), tmax (time to peak), MRT (mean residence time) and AUC. Should this formula be used in comparison of bioequivalency, all the parameters related to the kinetics of drugs will have been taken into account. The suggested parameter is: [formula: see text] However, amongst three carbamazepine generics-Tegretol, Temporol and Karazepin-the most desirable curve is that of Tegretol, while bioavailability values are respectively F = 0.86, 0.93, 0.85 and AUC = 145, 161, 127. The A parameter values are respectively 49.3, 47.2, 42.9.


Assuntos
Carbamazepina/farmacocinética , Adulto , Disponibilidade Biológica , Compartimentos de Líquidos Corporais , Peso Corporal/fisiologia , Química Farmacêutica , Estudos Cross-Over , Humanos , Masculino , Computação Matemática , Equivalência Terapêutica
12.
Encephale ; 16(3): 203-4, 1990.
Artigo em Inglês | MEDLINE | ID: mdl-2117522

RESUMO

In this study Lewis and ABO-Rh blood group systems were investigated in forty patients with bipolar affective disorder and forty healthy control subjects. The results were discussed in view of the literature.


Assuntos
Sistema ABO de Grupos Sanguíneos , Transtorno Bipolar/sangue , Antígenos do Grupo Sanguíneo de Lewis , Sistema do Grupo Sanguíneo Rh-Hr , Adulto , Humanos , Pessoa de Meia-Idade
13.
Artigo em Inglês | MEDLINE | ID: mdl-19964940

RESUMO

In this study, the scanning EMG technique was implemented to investigate electrophysiological cross-sections of the motor unit (MU) territories in healthy volunteers and in subjects with juvenile myoclonic epilepsy and spinal muscular atrophy. Measurements were taken intramuscularly by means of two concentric needle electrodes from biceps brachialis muscles. 3-D maps of the MU territories were plotted for each MU to determine the lengths of MU cross-section and the maximum amplitudes of each MU. There was evidence of a preponderance of large MUs in patients with juvenile myoclonic epilepsy.


Assuntos
Eletromiografia/métodos , Neurônios Motores , Contração Muscular , Músculo Esquelético/fisiopatologia , Epilepsia Mioclônica Juvenil/fisiopatologia , Recrutamento Neurofisiológico , Humanos
14.
Neurology ; 70(16): 1337-45, 2008 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-18413587

RESUMO

OBJECTIVE: The impact of migraine on physical, social, and emotional performance is considerable, yet it remains an underdiagnosed disorder. ID-Migraine is a validated migraine-screening tool developed to facilitate diagnosis. This study evaluated the validity and use of the Turkish version of the ID-Migraine screener (ID-Ms) in the workplace, and measured the impact of headache on disability, productivity, and quality of life among the workforce. METHODS: A total of 465 employees from four companies were interviewed for screening with the ID-Ms. Subjects were included in the study if they reported two or more headaches in the past 3 months and gave a positive answer to one of the two ID-Ms prescreening questions. Eligible subjects completed the ID-Ms, the Migraine Disability Assessment Questionnaire, and the Medical Outcomes Study 36-Item Short Form Health Survey. Subjects were then evaluated for confirmation of their diagnosis according to the International Classification of Headache Disorders, 2nd edition (ICHD-2) criteria. RESULTS: A total of 227 subjects (mean age 31.9 +/- 5.9 years; 65.6% women) completed the study. Migraine was diagnosed in 106 of the 227 subjects (46.7%) according to the ID-Ms and in 117 of the 227 subjects (51.5%) according to ICHD-2 criteria. The sensitivity of the ID-Ms was 70.9%, specificity was 79.1% and Cohen kappa value was 0.50. Workdays lost over the previous 3 months due to headache amounted to 8.7 +/- 9.5 days for migraine-positive and 4.9 +/- 6.6 days for migraine-negative subjects. CONCLUSION: The Turkish version of the ID-Migraine screener is a valid tool for identifying subjects with migraine in the workplace.


Assuntos
Inquéritos Epidemiológicos , Transtornos de Enxaqueca/diagnóstico , Medição da Dor/normas , Local de Trabalho/normas , Adolescente , Adulto , Feminino , Humanos , Indústrias/normas , Masculino , Pessoa de Meia-Idade , Transtornos de Enxaqueca/classificação , Transtornos de Enxaqueca/epidemiologia , Turquia/epidemiologia
15.
Cephalalgia ; 27(7): 788-92, 2007 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-17598760

RESUMO

The aim was to investigate neuromuscular transmission (NMT) by single-fibre EMG (SFEMG) in a large series of patients having migraine with aura (MA) or cluster headache (CH). Recent studies using SFEMG have shown subclinical dysfunction of NMT in MA and CH. Forty-three patients having MA, 51 with CH and 38 healthy control subjects underwent nerve conduction studies, EMG and SFEMG during voluntary contraction of the extensor digitorum communis muscle. Twenty different potential pairs were recorded and individual, mean and total abnormal individual jitter values were calculated. The results obtained from MA patients were compared with those from CH patients. In MA patients, 32 of 860 jitters were abnormally high, whereas 73 of 1020 of the jitters showed this abnormality in CH patients. None of the control subjects, five MA patients (11.6%) and 11 CH patients (21.6%) were designated as having subclinical NMT abnormality. Thus, patients having junction dysfunction were significantly more common in the CH group. The subclinical NMT abnormality shown by SFEMG is more common in CH than in MA. These two primary headache syndromes may have some shared functional abnormality of NMT constituents which is more evident in CH.


Assuntos
Cefaleia Histamínica/fisiopatologia , Eletromiografia/métodos , Enxaqueca com Aura/fisiopatologia , Condução Nervosa , Junção Neuromuscular/fisiopatologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Masculino , Nervo Mediano/fisiologia , Pessoa de Meia-Idade , Neurônios Motores/fisiologia , Contração Muscular/fisiologia , Neurônios Aferentes/fisiologia , Nervo Fibular/fisiologia , Nervo Tibial/fisiologia , Nervo Ulnar/fisiologia
16.
Eur Respir J ; 29(1): 143-8, 2007 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-16899484

RESUMO

Several ELISA tests based on mycobacterial antigens have been used for the rapid diagnosis of tuberculosis (TB), although demonstration of Mycobacterium tuberculosis in a smear or culture is the most reliable method. In the present study, the diagnostic value of 16-kDa and 38-kDa mycobacterial antigens was investigated in patients who were diagnosed with tuberculosis by clinical and/or bacteriological findings in Turkey. The PATHOZYME-TB Complex Plus commercial ELISA kit was used for measuring immunoglobulin G against 38-kDa and 16-kDa recombinant antigens. Humoral immune response was analysed in a group of 179 TB patients (143 smear-positive, 19 smear-negative, eight lymphadenitis and nine pleuritis), 15 inactive TB cases and in control groups consisting of 40 healthy volunteers and 20 subjects with pulmonary diseases other than TB. The sensitivity, specifity, positive predictive value and negative predictive value of the test were determined at 52.5%, 93.3%, 95.9% and 39.7%, respectively in TB cases. Antibodies were detected at above cut-off level in three (20%) out of 15 subjects with inactive TB. In conclusion, the ELISA test has a very good specifity and an acceptable sensitivity and positive predictive value. It is thought that it could be used in combination with other methods to increase diagnostic accuracy, especially for culture-negative tuberculosis cases, which are difficult to diagnose.


Assuntos
Antígenos de Bactérias/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Imunoglobulina G/sangue , Lipoproteínas/imunologia , Mycobacterium tuberculosis/imunologia , Tuberculose/sangue , Tuberculose/diagnóstico , Adolescente , Adulto , Idoso , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Reprodutibilidade dos Testes , Turquia
17.
Cephalalgia ; 27(11): 1201-5, 2007 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17919307

RESUMO

The aim of this study was to delineate any dysfunction of neuromuscular transmission (NMT) by single-fibre electromyography (SFEMG) in some rare types of migraine. Recent studies have shown subclinical dysfunction of NMT in migraine with aura and cluster headache by using SFEMG, whereas another recent study has shown NMT to be normal in familial hemiplegic migraine (FHM) with CACNA1A mutations. Thirty patients with rare primary headache syndromes [18 with sporadic hemiplegic migraine (SHM), six with FHM and six with basilar-type migraine (BM)] and 15 healthy control subjects without any headache complaints underwent nerve conduction studies, EMG and SFEMG during voluntary contraction of the extensor digitorum communis muscle. Ten to 20 different potential pairs were recorded and individual jitter values calculated. The results obtained from patient groups were compared with those from the normal subjects. Of 600 individual jitter values of the patients, 27 (4.5%) were abnormally high, whereas only 3/205 (1.5%) jitter values from normal subjects were abnormal. Abnormal NMT was found in 4/30 (13.3%) patients (three SHM and one BM), but in none of the control subjects. Only in SHM patients was the number of individual abnormal jitter values slightly but significantly different from normal controls. The present study demonstrates that subclinical NMT abnormality is slightly present in only SHM and BM patients, but not in FHM patients.


Assuntos
Transtornos de Enxaqueca/fisiopatologia , Condução Nervosa/fisiologia , Junção Neuromuscular/fisiopatologia , Adolescente , Adulto , Eletromiografia , Feminino , Humanos , Masculino , Nervo Mediano/fisiologia , Pessoa de Meia-Idade , Nervo Fibular/fisiologia , Nervo Tibial/fisiologia , Nervo Ulnar/fisiologia
18.
Acta Neurol Scand ; 114(5): 340-5, 2006 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-17022783

RESUMO

OBJECTIVE: To evaluate the value of single-fibre electromyography (SFEMG) with monopolar electrode (MNPE) in revealing neuromuscular transmission dysfunction. MATERIAL AND METHODS: We examined the extensor digitorum communis muscle by using single-fibre electrode (SFE) and MNPE sequentially, in randomly assigned 20 healthy volunteers and in 17 patients with known myasthenia gravis (MG). The high-pass filter setting was 3 kHz for MNPE. Ten individual jitter values were calculated for each electrode in every muscle. Repetitive nerve stimulation (RNS) test on trapezius muscle was performed on 15 patients. RESULTS: In controls, the mean jitter values were 27 +/- 9 (10-59) micro s with SFE, and 21 +/- 7.2 (9-56) micro s with MNPE (P = 0.001). In the MG group, the mean jitter values were 52.4 +/- 38 (12-221) micro s with SFE, and 51.8 +/- 34.7 (12-179) micro s with MNPE. Both electrodes identified junction dysfunction in 14 patients. RNS revealed decrement in four patients but 11. CONCLUSION: SFEMG with SFE is still the gold standard; however, SFEMG with MNPE is superior to RNS like SFEMG with SFE.


Assuntos
Eletromiografia/instrumentação , Miastenia Gravis/diagnóstico , Miastenia Gravis/fisiopatologia , Junção Neuromuscular/fisiopatologia , Adolescente , Adulto , Idoso , Estimulação Elétrica , Eletrodos/normas , Eletromiografia/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Contração Muscular/fisiologia , Músculo Esquelético/inervação , Músculo Esquelético/fisiopatologia , Junção Neuromuscular/fisiologia , Valor Preditivo dos Testes , Valores de Referência
19.
Cephalalgia ; 26(2): 180-6, 2006 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-16426273

RESUMO

The aim of this study was to investigate the characteristics of headache in patients with Behçet's disease (BD) seeking neurological consultation. Consecutive patients with BD seen within 1 year at the neuro-Behçet's out-patient clinic were studied using an electronic database according to the classification criteria of the International Headache Society. During a 12-month period 118 BD patients were admitted, and 98 had headaches. Migraine was the most common type of primary headache diagnosed in 45 patients (46.4%) in the whole headache group, followed by tension-type headache (TTH) in 26 cases (26.8%). Thirty-seven patients had secondary headaches mainly due to cerebral venous thrombosis or parenchymal neurological involvement of BD. Of these patients, 15 had both primary and secondary headaches. The primary headaches of 13 patients were exacerbated with systemic BD flare-ups, and four patients had migraine attacks triggered only by systemic BD activation which showed a good response to the treatment of systemic inflammation. The majority of the headaches of patients with BD do not indicate any neurological involvement; they are usually due to migraine or TTH. In a minority of patients, migraine associated with systemic inflammation of BD is notable.


Assuntos
Cefaleia/diagnóstico , Cefaleia/epidemiologia , Espondilite Anquilosante/diagnóstico , Espondilite Anquilosante/epidemiologia , Adulto , Comorbidade , Feminino , Cefaleia/classificação , Humanos , Masculino , Prevalência , Medição de Risco/métodos , Fatores de Risco , Turquia/epidemiologia
20.
Muscle Nerve ; 18(4): 435-9, 1995 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-7715629

RESUMO

According to Henneman's size principle, small motor units are recruited before large ones. It is commonly believed that this can be detected in routine conventional EMG recordings even among the earliest recruited motor units. That is, the MUP amplitude, area, and thickness should increase with recruitment order. We studied the first four motor unit potentials (MUPs) recruited within the pickup area of the electrodes. Data were obtained from 179 different sites in monopolar recordings and in 153 concentric recordings from 5 health subjects. In the pooled material, amplitude, area, and thickness increased slightly between consecutively recruited MUPs. However, at individual recording sites the size of consecutively recruited MUPs varied considerably. At some recording sites the first recruited MUP had the largest amplitude and the later MUPs has successively smaller amplitudes. We conclude that, at individual recording sites, the size principle cannot be detected in low threshold motor units with monopolar or concentric EMG electrodes. The reason for this is the small uptake area of these electrodes in relation to the motor unit territory.


Assuntos
Potenciais de Ação/fisiologia , Neurônios Motores/citologia , Neurônios Motores/fisiologia , Fibras Musculares Esqueléticas/citologia , Eletromiografia , Humanos , Fibras Musculares Esqueléticas/fisiologia
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