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1.
Auris Nasus Larynx ; 48(4): 565-570, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-33039196

RESUMEN

OBJECTIVE: To determine the optimal current intensity for supramaximal stimulation during electroneurography (ENoG) for facial palsy. METHODS: Forty patients with unilateral facial palsy (32 Bell's palsy, 7 Ramsay Hunt syndrome, and 1 temporal bone fracture) were enrolled. All patients were initially treated with intravenous steroid injections and examined using ENoG. Compound muscle action potentials (CMAPs) of the orbicularis oris muscle were measured on the paralyzed and healthy sides. Stimulation current intensity was varied every 5 mA from 20 mA to 50 mA using two recording methods (the midline and standard methods). The CMAPs of both sides were monitored to see whether they would saturate under the high current intensity stimulation or not. RESULTS: No obvious saturation of CMAPs was observed in either side with the midline or standard methods. Statistically, a current of 35 mA and above in the healthy side, and 30 mA and above in the paralytic side, resulted in no difference to each side when using the midline recording method. On the other hand, a current of 35 mA and above in the healthy side, and 25 mA and above in the paralytic side, resulted in no difference to each side when using the standard recording method. CONCLUSIONS: These results indicate that a current intensity of at least 35 mA is required to achieve supramaximal stimulation on the healthy side in a patient with unilateral facial nerve palsy. Clinically, for simplicity or standardization purposes, if the same current intensity is introduced bilaterally for ENoG measurements, adopting 40 mA (35 mA plus 10-20%) stimulation would be appropriate for supramaximal stimulation, while being cognizant of the potential effects of artifacts from other muscles.


Asunto(s)
Parálisis de Bell/terapia , Estimulación Eléctrica/métodos , Parálisis Facial/terapia , Potenciales de Acción , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Parálisis de Bell/fisiopatología , Niño , Músculos Faciales/fisiología , Parálisis Facial/fisiopatología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven
2.
Pesqui. vet. bras ; 34(6): 576-581, jun. 2014. tab
Artículo en Portugués | LILACS | ID: lil-716349

RESUMEN

A anestesia inalatória vem sendo amplamente difundida na medicina veterinária, no entanto seu uso em animais selvagens ainda é restrito, não sendo observado nenhum estudo referente à sua utilização na espécie Tayassu tajacu. O objetivo da pesquisa foi determinar a concentração alveolar mínima (CAM) do isofluorano em catetos e apresentar os efeitos desta administração sobre as variáveis hemodinâmicas e respiratórias, como também a qualidade da recuperação anestésica. Utilizou-se 10 animais, machos, com idade variando de 1 a 3 anos oriundos do Centro de Multiplicação de Animais Silvestres da Universidade Federal Rural do Semi-Árido, Brasil. Todos os animais tiveram anestesia induzida com 7mg.kg-1 de propofol e posteriormente foram conectados a circuito anestésico com isofluorano e oxigênio 100 por cento. O estímulo noceptivo supramáximo adotado foi pinçamento interdigital, o qual era realizado após 15 minutos de espera para cada concentração de isofluorano fornecida. Ao ser observada resposta negativa frente ao estímulo a concentração era reduzida em 20 por cento, quando verificada resposta positiva o estímulo era cessado, calculando-se a partir daí o valor da CAM. [...] A recuperação anestésica foi tranquila e rápida. Concluiu-se que a CAM do isofluorano para catetos foi maior que a observada em espécies afins. O isofluorano pode ser utilizado nesta espécie, sendo considerado seguro e eficaz. A recuperação dos animais após anestesia com isofluorano foi livre de excitação.


Inhalation anesthesia has been widespread in veterinary medicine. Nevertheless, its use in wild animals is still limited, having no studies on its use been observed in the species. The objective of the research was to determine the isoflurane minimum alveolar concentration (MAC) in peccaries and present the effects of its administration on the hemodynamic and respiratory variables, as well as data concerning the anesthesia recovery. The study used 10 male animals with age ranging from one to three years, from the Centro de Multiplicação de Animais Silvestres of Universidade Federal Rural do Semi-Árido, Brazil. All the animals had anesthesia induced with propofol 7mg.kg-¹, were intubated and connected to the anesthetic circuit with isoflurane and 100 percent oxygen. The supramaximal noxious stimulation used was the interdigital pinch, which was performed after 15 minutes of waiting for each provided isoflurane concentration. When negative response to the stimulus was observed, the concentration was reduced by 20 percent; when positive response was verified, the stimulus was stopped, being the CAM value calculated from that point. [...] Recovery was quiet and smooth. It was concluded that the isoflurane MAC for peccaries was greater than that observed in related species. Isoflurane can be used in this species, being considered safe and effective. The animals' recovery after anesthesia with isoflurane was free from excitement.


Asunto(s)
Animales , Periodo de Recuperación de la Anestesia , Anestesia por Inhalación/veterinaria , Artiodáctilos/metabolismo , Isoflurano/administración & dosificación , Isoflurano/efectos adversos , Isoflurano/sangre , Mecánica Respiratoria
3.
J Neurol Sci ; 331(1-2): 174-6, 2013 Aug 15.
Artículo en Inglés | MEDLINE | ID: mdl-23809191

RESUMEN

Useful diagnostic techniques for the acute phase of sciatic nerve palsy, an entrapment neuropathy, are not well established. The aim of this paper is to demonstrate the diagnostic utility of magnetic sacral motor root stimulation for sciatic nerve palsy. We analyzed the peripheral nerves innervating the abductor hallucis muscle using both electrical stimulations at the ankle and knee and magnetic stimulations at the neuro-foramina and conus medullaris levels in a patient with sciatic nerve palsy at the level of the piriformis muscle due to gluteal compression related to alcohol consumption. On the fourth day after onset, magnetic sacral motor root stimulation using a MATS coil (the MATS coil stimulation method) clearly revealed a conduction block between the knee and the sacral neuro-foramina. Two weeks after onset, needle electromyography supported the existence of the focal lesion. The MATS coil stimulation method clearly revealed a conduction block in the sciatic nerve and is therefore a useful diagnostic tool for the abnormal neurophysiological findings associated with sciatic nerve palsy even at the acute phase.


Asunto(s)
Magnetismo , Conducción Nerviosa/fisiología , Neuropatía Ciática/diagnóstico , Neuropatía Ciática/fisiopatología , Potenciales de Acción/fisiología , Adulto , Estimulación Eléctrica , Electromiografía , Humanos , Masculino
4.
Brain Stimul ; 6(4): 538-40, 2013 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-23085441

RESUMEN

BACKGROUND: The utilities of magnetic cervical motor root stimulation are well known for lesions in the lower part of the brachial plexus, but not for lesions in the other parts. OBJECTIVE: The aim of paper is to show the utilities of magnetic cervical motor root stimulation for lesions in the upper part of the brachial plexus. METHODS: We analyzed the brachial plexus using both electrical stimulation at Erb's point and magnetic cervical motor root stimulation in a patient with brachial plexopathy caused by tumor invasion. RESULTS: On the fourth day after onset, magnetic cervical motor root stimulation revealed abnormal findings in the upper part of the brachial plexus. Two weeks after onset, needle electromyography supported the existence of the focal lesion. CONCLUSION: Magnetic cervical motor root stimulation is useful in detecting abnormal findings in the upper part of the brachial plexus, even at the acute phase.


Asunto(s)
Neuropatías del Plexo Braquial/diagnóstico , Plexo Braquial/lesiones , Electrodiagnóstico/métodos , Conducción Nerviosa/fisiología , Raíces Nerviosas Espinales/fisiopatología , Plexo Braquial/fisiopatología , Neuropatías del Plexo Braquial/fisiopatología , Estimulación Eléctrica , Electromiografía , Humanos , Masculino , Persona de Mediana Edad
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