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Are nerve conduction studies altered in functional neurological disorders?, 2022, Sukockienė et al

Discussion in 'Other psychosomatic news and research' started by Andy, Jun 28, 2022.

  1. Andy

    Andy Committee Member

    Messages:
    17,094
    Location:
    Hampshire, UK
    Highlights

    Central nervous system activity influences generation of F-waves.
    • We report F-wave abnormalities in a patient with a functional neurological disorder.
    • F-waves can be useful in characterising the origin of undetermined muscle weakness.

    Abstract
    Background
    Functional neurological disorders represent conditions without a readily identifiable origin or laboratory-supported diagnostic. We report a case of functional neurological disorder, presenting with muscle weakness with alterations in F-waves on the affected side.

    Case report
    A retrospective case review of a patient seen in clinic. Electrophysiological evaluation included nerve conduction studies, including recording of F-waves in lower limbs, and needle EMG. A patchy sensory loss and unilateral muscle weakness of the left lower limb persisted nine days after a 40-year-old female patient developed bilateral lower limb weakness following a laparoscopic surgery. MRI was negative for radicular compression, myelopathy, or lumbosacral plexopathy. F-waves of the peroneal and tibial nerves on the left were absent or of reduced persistence and amplitude compared to the asymptomatic right side.

    Significance
    The observation of unilateral alterations of F-wave parameters could be interpreted as an asymmetrical decrease of alpha motor neuron excitability on L4 – S2 segments. In the absence of peripheral nervous system dysfunction or a structural lesion, the results here suggest a central control dysfunction or point to a more complex peripheral role. Further research is necessary to determine the frequency of these findings in a larger group of patients while incorporating other late responses, such as H (Hoffman) reflex, and measures of cortical excitability.

    Open access, https://www.sciencedirect.com/science/article/pii/S2467981X22000221
     
    Michelle, Lilas, cassava7 and 5 others like this.
  2. Snow Leopard

    Snow Leopard Senior Member (Voting Rights)

    Messages:
    3,714
    Location:
    Australia
    Isn't this simply a case of misdiagnosis?
     

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