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KMID : 1130620140100010010
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Journal of Clinical Neurology
2014 Volume.10 No. 1 p.10 ~ p.16
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Axon Count and Sympathetic Skin Responses in Lumbosacral Radiculopathy
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Tilki Hacer Erdem
Coskun Melek
Akdemir Neslihan Unal
Incesu Lutfi
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Abstract
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Background and Purpose: Electrodiagnostic studies can be used to confirm the diagnosis of lumbosacral radiculopathies, but more sensitive diagnostic methods are often needed to measure the ensuing motor neuronal loss and sympathetic failure.
Methods: Twenty-six patients with lumbar radiculopathy and 30 controls were investigated using nerve conduction studies, motor unit number estimation (MUNE), testing of the sympathetic skin response (SSR), quantitative electromyography (QEMG), and magnetic resonance myelography (MRM).
Results: Using QEMG as the gold standard, the sensitivity and specificity of MUNE for the abductor hallucis longus muscle were 71.4% and 70%, respectively. While they were 75% and 68.8%, respectively, when used MRM as gold standard. The sensitivity and specificity of MUNE for the extensor digitorum brevis muscle were 100% and 84.1%, respectively, when the peroneal motor amplitude as the gold standard. The SSR latency was slightly longer in the patients than in the controls.
Conclusions: MUNE is a simple and sensitive test for evaluating autonomic function and for diagnosing lumbosacral radiculopathy in patients. MUNE could be used routinely as a guide for the rehabilitation of patients with radiculopathies. SSR measurements may reveal subtle sympathetic abnormalities in patients with lumbosacral radiculopathy.
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KEYWORD
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lumbosacral radiculopathy, nerve conduction study, quantitative electromyography, motor unit number estimation, sympathetic skin response
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