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At the nerve ending in the neuromuscular junction, where the impulse is transferred to the muscle cell, the nerve impulse leads to the opening of voltage-gated calcium channels (VGCC), the influx of calcium ions into the nerve terminal, and the calcium-dependent triggering of synaptic vesicle fusion with plasma membrane.
Sensory neuronopathy is diagnosed clinically, based on signs and symptoms, along with nerve conduction studies. [1] Ataxia in the upper and lower extremities at onset or at full development, asymmetric distribution of sensory loss, sensory loss not being restricted to the lower limbs (as in length dependent axonal polyneuropathy) are specific ...
Peripheral neuropathy may be classified according to the number and distribution of nerves affected (mononeuropathy, mononeuritis multiplex, or polyneuropathy), the type of nerve fiber predominantly affected (motor, sensory, autonomic), or the process affecting the nerves; e.g., inflammation (), compression (compression neuropathy), chemotherapy (chemotherapy-induced peripheral neuropathy).
This usually starts with the observation of bulk, possible atrophy or loss of muscle tone. Neuromuscular disease can also be diagnosed by various blood tests and using electrodiagnostic medicine tests [23] including electromyography [24] (measuring electrical activity in muscles) and nerve conduction studies. [25]
The nerve conduction study is often combined with needle electromyography. The Department of Health and Human Services Inspector General recently identified the use of NCSs without a needle electromyography at the same time a sign of questionable billing. [9] The nerve conduction study consists of the following components:
Among the signs/symptoms are the following (different symptoms are caused by different nerves, such as the foot drop caused by the peroneal nerve [4]): Other HNPP symptoms can include: Partial hearing loss and facial numbness (cranial nerves can be afflicted by HNPP), intolerable fatigue and pain, sensation loss and muscle weakness in the hands ...
Electromyography and nerve conduction studies: These diagnostic tests of the peripheral nervous system are especially useful in evaluating diseases of the muscles, nerves, and nerve roots. The basis of these tests is recording electrical activity of the muscles and the passage of electric signal along the nerves in the limbs.
Although diseases often are suggested by the physical examination and history alone, tests that may be employed include electrodiagnostic testing, serum protein electrophoresis, nerve conduction studies, urinalysis, serum creatine kinase (CK) and antibody testing; nerve biopsy is done sometimes. [1] [3]