Bilateral clinical neurophysiological assessment of median nerve in carpal tunnel syndrome patients

✍ Scribed by Luca Padua; Mauro LoMonaco; Bruno Gregori; Vincenzo Di Lazzaro; Roberto Padua; Pietro Tonali

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 23 KB
• Volume: 21
• Category: Article
• ISSN: 0148-639X
• DOI: 10.1002/(sici)1097-4598(199802)21:2<264::aid-mus24>3.0.co;2-0

✦ Synopsis

tal status improved, but he did not show any improvement in muscle strength for 2 months, following which he was transferred to another facility.

Although the absence of F waves is often seen with acute demyelinating polyneuropathy, 4 this has also been described as the sole abnormality, early in the course of patients with spinal cord lesions such as transverse myelitis and the anterior spinal artery syndrome. 1,7 To our knowledge, this finding has not been described in heat stroke. During the stage of spinal shock following spinal cord injury, H reflexes may be absent initially but tend to recover within days, while F waves continue to be absent for weeks. 5 The few neuropathologic reports in patients with heat stroke have described abnormalities in the cerebral cortex, cerebellum, and skeletal muscles. 6 Total loss of spinal motor neurons has been described in a patient with acute quadriparesis due to heat stroke. 3 In our patient, the abundance of fibrillation potentials and positive sharp waves very early in the course of his illness was most likely due to direct muscle damage due to heat stroke; this was supported by elevated CPK and myoglobinuria. The presence of normal H reflexes, with the persistence of absent F waves, was most likely caused by a myelopathy due to heat stroke.