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6 results

  • Long Latency Reflexes in Clinical Neurology: A Systematic Review

  • Debjyoti Dhar, Nitish Kamble, Pramod Kumar Pal
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 50 / Issue 5 / September 2023
    Published online by Cambridge University Press:
    08 July 2022, pp. 751-763
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  • Background:

    Long latency reflexes (LLRs) are impaired in a wide array of clinical conditions. We aimed to illustrate the clinical applications and recent advances of LLR in various neurological disorders from a systematic review of published literature.

    Methods:

    We reviewed the literature using appropriately chosen MeSH terms on the database platforms of MEDLINE, Web of Sciences, and Google Scholar for all the articles from 1st January 1975 to 2nd February 2021 using the search terms “long loop reflex”, “long latency reflex” and “C-reflex”. The included articles were analyzed and reported using synthesis without meta-analysis (SWiM) guidelines.

    Results:

    Based on our selection criteria, 40 articles were selected for the systematic review. The various diseases included parkinsonian syndromes (11 studies, 217 patients), Huntington’s disease (10 studies, 209 patients), myoclonus of varied etiologies (13 studies, 127 patients) including progressive myoclonic epilepsy (5 studies, 63 patients) and multiple sclerosis (6 studies, 200 patients). Patients with parkinsonian syndromes showed large amplitude LLR II response. Enlarged LLR II was also found in myoclonus of various etiologies. LLR II response was delayed or absent in Huntington’s disease. Delayed LLR II response was present in multiple sclerosis. Among the other diseases, LLR response varied according to the location of cerebellar lesions while the results were equivocal in patients with essential tremor.

    Conclusions:

    Abnormal LLR is observed in many neurological disorders. However, larger systematic studies are required in many neurological disorders in order to establish its role in diagnosis and management.

  • Electroencephalography Attenuations in Adults: Clinical Correlates

  • Gary Hunter, Ryan Verity
  • Journal:
    Canadian Journal of Neurological Sciences / Volume 48 / Issue 4 / July 2021
    Published online by Cambridge University Press:
    13 November 2020, pp. 570-574
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  • Spontaneous intermittent generalized attenuations (SIGAs) are defined as a transient decrease in amplitude of electroencephalography (EEG) activity in response to a physiologic process, external stimuli, or as a result of a pathologic condition. We seek to investigate their relationship to clinical outcomes. Demographic information, modified Rankin Scale (mRS), and clinical information were noted on 22 consecutive patients with SIGAs on their EEG. 12 of the 22 patients (54.5%) died, and 12 patients (54.5%) were admitted to the intensive care unit or coronary care unit. Future studies should attempt to prospectively compare outcomes among patients with SIGAs against a control group.

  • Section 4 - Neurointensive care

  • Edited by Basil F. Matta, David K. Menon, Martin Smith
  • Book:
    Core Topics in Neuroanaesthesia and Neurointensive Care
    Published online:
    05 December 2011
    Print publication:
    13 October 2011, pp 271-497

  • Summary

    Clinical neurophysiology encompasses a variety of diagnostic tests including EEG, nerve conduction studies, electromyography, evoked potentials and polysomnography. This chapter describes the tests that are most widely used for monitoring during neuroanaesthesia and neurocritical care, specifically, EEG, somatosensory evoked potentials (SSEPs), brainstem auditory evoked potentials, motor evoked potentials (MEPs) and electromyography (EMG). The main indications for EEG are in the diagnosis and management of epilepsy, sleep studies and neuromonitoring. Evoked potentials are the electrical response from the nervous system to an external stimulus. There are two types of EPs: sensory and motor. SSEPs monitor the integrity of sensory pathways, including peripheral nerves, and MEPs the motor pathways. Electromyography is a technique used to evaluate the electrical activity in muscle fibres. Two types of EMG monitoring commonly used include: recording spontaneous electrical activity and recording responses generated by stimulation of motor nerves.

  • 7 - Restless legs syndrome and periodic limb movement disorder

  • from SECTION 2 - SLEEP DISORDERS
  • Edited by Harold R. Smith, University of California, Irvine, Cynthia L. Comella, Birgit Högl
  • Book:
    Sleep Medicine
    Published online:
    08 August 2009
    Print publication:
    10 April 2008, pp 113-128

  • Summary

    The most characteristic features of the restless legs syndrome (RLS) are uncomfortable sensations in one or more usually lower limbs, associated with an urge to move the affected limbs. Those sensations vary widely in severity from merely annoying to significantly unpleasant. Periodic limb movements disorder (PLMD) can only be diagnosed when a polysomnographic recording has been performed. In the past few decades neuroimaging, neurophysiological, and pharmacological studies have contributed to the development of a variety of hypotheses on the pathogenesis of the disorder. The usually immediate and striking efficacy of treatment with dopaminergic agents, and the observation that dopamine receptor antagonism can clinically worsen RLS symptoms, indicates a central role of the dopaminergic system in RLS pathophysiology. Peripheral polyneuropathy, which, similar to RLS, often causes paresthesias and pain in the limbs and tends to worsen at night, is probably the most common differential diagnosis.