RESUMO
Hereditary neuropathy with liability to pressure palsies (HNPP) is an autosomal-dominant disorder associated with recurrent mononeuropathies following compression or trivial trauma. Reports on sciatic neuropathy as the presenting manifestation of HNPP are very scarce. We report on a 21-year-old previously healthy man who was admitted with sensorimotor deficits in his left leg. He had no history of preceding transient episodes of weakness or sensory loss. Clinical and electrophysiological examinations were consistent with sciatic neuropathy. Cerebrospinal fluid investigation and MRI of the nerve roots, plexus, and sciatic nerve did not indicate the underlying aetiology. When extended electrophysiological tests revealed multiple subclinical compression neuropathies in the upper limbs, HNPP was contemplated and eventually confirmed by genetic testing.
Assuntos
Neuropatia Hereditária Motora e Sensorial/diagnóstico , Neuropatia Hereditária Motora e Sensorial/genética , Neuropatia Ciática/genética , Adulto , Artrogripose/diagnóstico , Artrogripose/genética , Artrogripose/terapia , Deleção Cromossômica , Diagnóstico Diferencial , Terapia por Estimulação Elétrica/métodos , Seguimentos , Neuropatia Hereditária Motora e Sensorial/terapia , Humanos , Masculino , Síndromes de Compressão Nervosa/diagnóstico , Síndromes de Compressão Nervosa/genética , Síndromes de Compressão Nervosa/terapia , Paralisia/diagnóstico , Paralisia/genética , Paralisia/terapia , Modalidades de Fisioterapia , Pressão , Neuropatia Ciática/diagnóstico , Neuropatia Ciática/terapia , Adulto JovemRESUMO
This paper presents functional regeneration of severed peripheral nerve using a polymer-based implantable electrical stimulator. A polyimide based conduit electrode was made by micro-fabrication and a stimulation chip was designed to generate biphasic current pulse for electrical stimulation. The stimulation chip was packaged with a battery using silicone elastomer, and integrated with the electrode. The implantable electrical stimulator was implanted in the rat sciatic nerve with 7 mm gap. The electrical stimulation was applied for periods of one, two and four weeks between the proximal and the distal nerve stumps. After four weeks of post-operations, the degree of regeneration was evaluated through walking track assessments and by measuring neural response of the regenerated nerve. Based on these results, electrical stimulation, especially for two weeks of stimulation, could accelerate functional regeneration of the severed nerve.
Assuntos
Fontes de Energia Elétrica , Terapia por Estimulação Elétrica/instrumentação , Regeneração Nervosa , Próteses e Implantes , Recuperação de Função Fisiológica , Neuropatia Ciática/diagnóstico , Neuropatia Ciática/terapia , Animais , RatosRESUMO
The channel bridging, signal regenerating, and functional rebuilding of injured nerves is one of the most important issues in life science research. In recent years, some progresses in the research area have been made in repairing injured nerves with microelectronic neural bridge. Based on the previous work, this paper presents a neural signal detection and functional electrical stimulation (FES) driving system with using high performance operational amplifiers, which has been realized. The experimental results show that the designed system meets requirements. In animal experiments, sciatic nerve signal detection, regeneration and function rebuilding between two toads have been accomplished successfully by using the designed system.