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Spremljanje regeneracije perifernega živca z uporabo elektrofizioloških metod : predstavitev kliničnega primeraKlopčič Spevak, MilicaFirst clinical signs of peripheral nerve regeneration are positive Tinel's sign and return of sensory perception from previously anaesthetic skin area. Early nerve regeneration is characterized by ... erroneous senzory localization. Touch of distal finger skin patient recognize proximally or on the other finger. When patient senses touch, perception can be evidenced by Sympathetic skin responses (SSR) at asymptomatic hand after electrical stimulation of symptomatic skin area. Method is easy and quick. Similar evidence, with more informations, can be evidenced by recording Cortical somatosensory evoked potentials (SEP) after electrical stimulation of affected and contralateral (unaffected) skin area. Dynamic changes of SEP features in time enable follow up of regeneration process. Diagnostic sensitivity is high, specificity is low. Method involves much more time and specific knowledge of medical professionals. Antidromic sensory neurography is easy to perform, highly specific, but not sensitive for early sensory nerve regeneration. When number of regenerating sensory fibers is big enough for antidromic sensory neurogram of 1-3 uV (20-50 uV on asymptomatic finger), SEP features became normal and do not change by progress of reinnervation. Because of 100% diagnostic specificity, and simple technique, when sensory neurogram is possible to record, sensory neurography is recommended for follow up of sensory fibers regeneration. Needle EMG confirms muscle fibre reinnervation earlier than manual muscle test. EMG proof of motor fibre reinnervation is 1-2 months delayed after proof of sensory fibres reinnervation. Year and a half follow up of patient with injury and suture of median and ulnar nerves at wrist level is pressented.Vir: Rehabilitacija. - ISSN 1580-9315 (Letn. 4, št. 1-2, 2005, str. 32-38)Vrsta gradiva - članek, sestavni del ; neleposlovje za odrasleLeto - 2005Jezik - slovenskiCOBISS.SI-ID - 597097
Avtor
Klopčič Spevak, Milica
Teme
živec, obnavljanje |
senzorična nevrografija |
kortikalni somatosenzorični evocirani potenciali |
simpatični kožni odziv |
igelna elektromiografija |
motorična nevrografija |
motorična nevrografija |
nerve regeneration |
sensory neurography |
cortical somatosensory evoked potentials |
sympathetic skin responses |
needle EMG |
motor neurography
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