The effect of adding whole-body vibration exercises to home exercise program on muscle strength in patients with post-polio syndrome.

Objectives: This study aims to understand the effectiveness of whole-body vibration (WBV) exercises performed with home exercise program in patients with post-polio syndrome (PPS) in terms of muscle strength, fatigue, the quality of life, and laboratory parameters. Patients and methods: Between October 2015 and March 2016, a total of 14 patients (7 males, 7 females; mean age: 45.1±6.6 years; range, 34 to 57 years) who were diagnosed with PPS were included in the study. The patients were randomized into two groups: the first group received WBV, home exercise program and patient education while the second (control) group received home exercise program and patient education. The patients were evaluated by knee isometric and isokinetic peak torque, Fatigue Severity Scale (FSS), Fatigue Impact Scale (FIS), Nottingham Health Profile (NHP), serum creatine kinase, aspartate aminotransferase, and alanine aminotransferase at baseline and at the end of the treatment. Results: At the end of the treatment, the exercise program administered to the patients was found to be effective in increasing knee muscle strength in PPS patients (p<0.05). This difference was more apparent on the sequela side, isometric extension peak torque in the group with WBV. There was no significant change in the markers of muscle damage or NHP in both groups. Conclusion: Inclusion of WBV in home exercise program in PPS patients does not seem to be superior, except for reducing the effect of fatigue on the patient's life.

Large motor unit territories by scanning electromyography in patients with juvenile myoclonic epilepsy.

Juvenile myoclonic epilepsy is a genetically inherited disorder characterized by myoclonic jerks and generalized seizures. It has been proposed that patients with juvenile myoclonic epilepsy have larger motor units (MUs) than normals by MU number estimation and macro electromyography techniques. In this study, an experimental setup for scanning electromyography was built to investigate electrophysiologic cross-sections of the MU territories in 9 patients with juvenile myoclonic epilepsy, 3 patients with spinal muscular atrophy, and 10 healthy volunteers. Scanning electromyography was performed on the biceps brachii muscle. For each MU, three-dimensional maps of the MU territories were plotted. The length of MU cross-section and the maximum amplitude of each MU were measured from these maps and compared among the three groups of subjects. Like spinal muscular atrophy patients, patients with juvenile myoclonic epilepsy had significantly larger MU territories than normal controls.

Assessment of long- and short-term neurotoxic effects of glass ionomer bone cement by electromyography and histopathologic examination: experimental study.

OBJECTIVE: The objective of this study was to investigate the possible neurotoxic effects of bone cement on the peripheral nerves. STUDY DESIGN: Experimental study. SETTING: Teaching and research hospital. METHODS: Twenty New Zealand rabbits were included in this study. The sciatic nerves of both legs of the 10 rabbits were exposed surgically under general anesthesia and closed primarily without any intervention and constituted the control group (group 1). Following surgical exploration, glass ionomer cement (GIC) was applied to the left sciatic nerves of the 10 rabbits for 10 seconds and then aspirated (group 2). GIC material was also applied to the right sciatic nerves of these rabbits but without aspiration (group 3). OUTCOME MEASURES: All rabbits were sacrificed at the end of 8 weeks postoperatively following electromyographic investigation. The sections were stained with hematoxylin-eosin and Immune Olig 2 staining technique for histopathologic examination under light microscopy. RESULTS: There was no statistically significant difference in distal latency, which indicates the conduction speed of the nerve, between all groups by electromyography. Histopathologic examination of all specimens revealed no demyelinization or axonal degeneration, and all had an intact myelin structure. There was no statistically significant difference in inflammation of the specimens between groups. (p>.05). CONCLUSION: GIC has no neurotoxic effects on the nerves in short- and long-term applications.

Reduced axon number in juvenile myoclonic epilepsy demonstrated by motor unit number estimation analysis.

Some conventional and quantitative EMG studies have already demonstrated a subclinical lower motor neuron involvement in juvenile myoclonic epilepsy (JME). Our aim was to investigate this subclinical involvement by using motor unit number estimation (MUNE) analysis with modified McComas' technique. We enrolled 75 consecutive JME patients and 26 normal controls. All subjects underwent motor and sensory nerve conduction studies, concentric needle EMG and MUNE analysis of the M. abductor pollicis brevis (APB) and M. tibialis anterior (TA). The clinical and EEG findings were evaluated to correlate with MUNE values. MUNE values of the APB (54+/-25) and TA (35+/-17) muscles were significantly lower in the JME group (p<0.001) when compared to the normal controls (109+/-24 and 80+/-26 for APB and TA muscles, respectively). Our findings show that anterior hom cells were subclinically affected in some JME patients, suggesting a shared background for both JME phenotype and grey matter disorganization in spinal cord.

Clinical and magnetic resonance imaging findings of HIV-negative patients with neurosyphilis.

There have been no serial studies about neuroradiological findings of neurosyphilis in the literature. There have been only case reports concerning HIV negative patients with neurosyphilis. We present 8 HIV negative neurosyphilis patients two of whom are women. The mean age of the patients was 48 years+/-12.37. Five of the 8 patients had general paresis, two optic atrophy and one multiple cranial neuropathies. The CSF findings were quite similar in 6 of 8 patients. In half of the patients cranial MRI showed mild cerebral atrophy. Nonspecific hyperintense small foci in 3 patients are thought to be related to syphilis. Hyperintensity involving bilateral medial and anterior temporal regions more prominent on the left side was seen in one of the patients with general paresis. This finding may be due to cytotoxic edema associated with status epilepticus and may mimic herpes simplex and other limbic encephalitides. Though not typical, certain MRI findings guides for the diagnosis of neurosyphilis.

A new nerve-muscle unit model for peripheral nerve studies in rats.

Ischiatic, femoral and tibial nerves are commonly utilized in the studies of peripheral nerve surgery in rats. The authors present a new nerve-muscle unit model in which the nerve is distal enough to minimize morbidity and the muscle is convenient for all electromyographic studies. Twenty-five Wistar-Albino rats were used. In the control group; normal electromyography and histology were demonstrated in the lateral tibial nerve (LTN) and in the flexor digiti quinti brevis (FDQB) muscle. In experimental group I; a 0.5 cm nerve gap was made in the LT nerve and the proximal end was buried in the muscle in order to prevent reinnervation. In experimental group II, the LTN was cut and repaired primarily. In both groups I and II, electromyographic and histologic studies were performed at 6 and 12 weeks. In study group I, atrophic and degenerative findings were observed and in study group II, only regenerative findings were observed. The authors concluded that the LT nerve-FDQB muscle unit is a convenient model for peripheral nerve studies, with the advantages of easy dissection, wide exposure, and minimal morbidity. This model is also convenient for electromyographic and histologic evaluation.

Muscle ultrasonography and electromyography correlation for evaluation of floppy infants.

Floppiness in an infant may have a number of different etiologies from disorders of the brain to spinal cord lesions, neuropathies, neuromuscular junction disorders and myopathies. In this study we aimed to investigate the correlation of muscle ultrasonography (US) and electromyography (EMG) in the diagnosis of floppy infants. The study encompassed 41 floppy infants aged 2-24 months. The muscle US and EMG examinations were performed without awareness of the clinical diagnosis. The final diagnosis was established by molecular genetic tests or muscle/nerve biopsy. The neurogenic group consisted of 16 infants according to their US and EMG findings. Fifteen of them had spinal muscular atrophy proven by genetic analysis and one had polyneuropathy diagnosed by nerve biopsy. Six infants were in the myopathic group according to their muscle US and EMG results. All of them underwent muscle biopsy and microscopic examination revealed five congenital muscular dystrophy and one glycogen storage disease. In two infants the US and EMG data conflicted. Their biopsies were also insufficient for the diagnosis. Seventeen infants had normal US and EMG findings but pathologic cranial magnetic resonance imaging or metabolic/genetic tests. They were considered in the group of central hypotonia. Our results suggest a high concordance of US and EMG findings in the diagnostic work-up of neurogenic and myopathic disorders.