RESUMO
We assessed peripheral nerve function during and after lower-limb lengthening by callotasis in 14 patients with short stature, using motor conduction studies. Four patients with short stature of varying aetiology showed unilateral and one showed bilateral weakness of foot dorsiflexion. Both clinical and electrophysiological abnormalities consistent with involvement of the peroneal nerve were observed early after starting tibial callotasis. There was some progressive electrophysiological improvement despite continued bone distraction, but two patients with Turner's syndrome had incomplete recovery. A greater percentage increase in tibial length did not correspond to a higher rate of peroneal nerve palsy. The function of the posterior leg muscles and the conduction velocity of the posterior tibial nerve were normal throughout the monitoring period. The F-wave response showed a longer latency at the end of the bone distraction than in basal conditions; this is probably related to the slowing of conduction throughout the entire length of the nerve.
Assuntos
Nanismo/cirurgia , Eletromiografia , Fêmur/cirurgia , Osteogênese por Distração , Nervo Fibular/fisiologia , Tíbia/cirurgia , Nervo Tibial/fisiologia , Acondroplasia/complicações , Acondroplasia/fisiopatologia , Adolescente , Adulto , Potencial Evocado Motor/fisiologia , Feminino , Doenças do Pé/etiologia , Doenças do Pé/fisiopatologia , Humanos , Perna (Membro) , Masculino , Monitorização Fisiológica , Neurônios Motores/fisiologia , Debilidade Muscular/etiologia , Debilidade Muscular/fisiopatologia , Músculo Esquelético/inervação , Músculo Esquelético/fisiopatologia , Condução Nervosa/fisiologia , Osteogênese por Distração/efeitos adversos , Paralisia/etiologia , Paralisia/fisiopatologia , Doenças do Sistema Nervoso Periférico/etiologia , Doenças do Sistema Nervoso Periférico/fisiopatologia , Tempo de Reação/fisiologia , Síndrome de Turner/complicações , Síndrome de Turner/fisiopatologiaRESUMO
Autonomic function has been studied in 30 insulin-dependent diabetic children and adolescents, through five cardiovascular tests. A significant difference between the diabetic and the control subjects was found in heart rate variations after deep breathing and after standing. Fifty percent of our patients showed an altered response to one or more cardiovascular tests. Although clinical manifestations of autonomic dysfunction are not frequent in young insulin-dependent patients, early signs of functional alterations are detectable in a high percentage of them.