{"title":"Neurophysiologische Diagnostik bei neuropathischen Schmerzen","authors":"Nurcan Üçeyler","doi":"10.1016/j.neulab.2019.07.002","DOIUrl":"10.1016/j.neulab.2019.07.002","url":null,"abstract":"<div><p>Neuropathische Schmerzen sind häufig und schränken die Lebensqualität betroffener Patienten erheblich ein. Die Diagnostik basiert in erster Linie auf der ausführlichen Schmerzanamnese und der klinisch-neurologischen Untersuchung zur Ortung der zugrunde liegenden Störung. Verfahren, mit denen (neuropathische) Schmerzen abgebildet oder gemessen werden können gibt es nicht, allerdings wurden insbesondere zur Untersuchung der schmerzleitenden kleinkalibrigen Nervenfasern zahlreiche Methoden etabliert, die bei der differenzialdiagnostischen Abklärung eingesetzt werden können (s. Tabelle). Neben der Anwendung von speziellen Fragebögen, psychophysischen Tests und morphologischen Untersuchungen können neurophysiologische Verfahren wie evozierte Potenziale und Microneurographie zum Einsatz kommen. Im vorliegenden Artikel werden diese Verfahren vorgestellt und in den Kontext der Diagnostik bei neuropathischen Schmerzen gestellt.</p></div><div><p>Neuropathic pain is frequent and leads to relevant impairment of health related quality of life. Diagnostics are primarily based on a detailed pain history and clinical neurological examination to locate the underlying damage. There are no methods to image or measure (neuropathic) pain. However, several novel techniques have been established to investigate small caliber nerve fibers conducting pain. Besides using special pain questionnaires for neuropathic pain, psychophysic tests, and morphological examinations, neurophysiological tests such as evoked potentials and microneurography may be used. These tests are characterized in this article and their impact on the diagnostics in neuropathic pain is discussed.</p></div>","PeriodicalId":35874,"journal":{"name":"Neurophysiologie-Labor","volume":"41 3","pages":"Pages 172-179"},"PeriodicalIF":0.0,"publicationDate":"2019-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.neulab.2019.07.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46391771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neurophysiologische und sonographische Diagnostik des Guillain-Barré-Syndroms","authors":"Thomas Regenspurger","doi":"10.1016/j.neulab.2019.04.002","DOIUrl":"10.1016/j.neulab.2019.04.002","url":null,"abstract":"<div><p>Schwerpunkt des Artikels stellt die elektrophysiologische und sonologische Diagnostik bei Verdacht auf ein Guillain-Barré-Syndrom (GBS) dar. Die frühzeitige Diagnosestellung eines GBS erfolgt in erster Linie nach klinischen Kriterien. Neurophysiologische Untersuchungen liefern weitere unterstützende Hinweise auf eine Demyelinisierung. Die diagnostischen Kriterien eines akuten GBS sind gleichzeitiger Nachweis von Nervenleitgeschwindigkeits- und Amplitudenreduktion ohne wesentliche Dispersion, Leitungsblock und F-Wellen-Veränderungen – festgestellt zur diagnostischen Sicherung innerhalb der ersten drei Wochen. Nervenultraschalluntersuchungen (periphere motorische Nerven, Zervikalnerven, N. vagus) können zusätzliche, frühzeitige Beiträge zur Diagnosefindung, Verlaufsbeurteilung und Prognose liefern.</p></div><div><p>The aim of this reviewed article is diagnostic approach in GBS using electrophysiology and ultrasound. Early diagnosis of GBS is mainly based on clinical criteria. However, neurophysiological examinations provide further information about demyelination. Diagnostic criteria of acute GBS (within 3 weeks) are reduced nerve conduction velocity and reduction of amplitude at the same time without any essential dispersion, conduction block and changes of F-waves. Ultrasound examination of nerves (peripheral motor nerves, cervical roots and probably vagus nerv) can provide additional information for early diagnosis, follow up and prognosis.</p></div>","PeriodicalId":35874,"journal":{"name":"Neurophysiologie-Labor","volume":"41 2","pages":"Pages 99-112"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.neulab.2019.04.002","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49221377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sonographie des N. vagus – Methodik und Indikation","authors":"Johann Pelz , David Weise","doi":"10.1016/j.neulab.2019.03.001","DOIUrl":"10.1016/j.neulab.2019.03.001","url":null,"abstract":"<div><p>Der N. vagus wird zunehmend zur Beantwortung wissenschaftlicher aber auch klinischer Fragestellungen mittels Ultraschall untersucht. Dieser Artikel gibt zunächst einen kurzen Überblick über die Anatomie des N. vagus bevor die wichtigsten Indikationen diskutiert werden. Anschließend liegt der Fokus auf der ausführlichen Darstellung der praktischen Ultraschalluntersuchung mit Angabe von Normalwerten.</p></div><div><p>The vagus nerve is increasingly examined by ultrasound addressing both, scientific and clinical questions. This article gives a short overview about the vagal anatomy before discussing the most important indications for the ultrasound examination of the vagus nerve. Subsequently, the focus is laid on the detailed description of the practical aspects of the ultrasound examination. Finally, normal reference values are given.</p></div>","PeriodicalId":35874,"journal":{"name":"Neurophysiologie-Labor","volume":"41 2","pages":"Pages 91-98"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.neulab.2019.03.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47618573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Dystoner Tremor? – ein Fallbericht","authors":"David Weise","doi":"10.1016/j.neulab.2019.04.003","DOIUrl":"10.1016/j.neulab.2019.04.003","url":null,"abstract":"<div><p>Die neue Klassifikation von Tremor, der häufigsten Bewegungsstörung basiert auf einem 2-Achsen-Prinzip, einer phänomenologischen Beschreibung des Tremors inklusiver klinischer Charakteristika zum einen und einer ätiologischen Einordnung zum Anderen. Anhand eines Fallbeispiels von einer Patientin mit einem mutmaßlich dystonen Tremor soll diese neue Klassifikation angewendet und die Herausforderungen der differentialdiagnostischen Einordnung dargestellt werden.</p></div><div><p>The new classification of tremors, the most frequent movement disorder, is based on two axes, a phenomenological description of the tremor including clinical characteristics on the one hand and an etiological classification on the other hand. On the basis of the case report of a patient with presumably dystonic tremor the new classification was applied to the challenges of the differential diagnostics discussed.</p></div>","PeriodicalId":35874,"journal":{"name":"Neurophysiologie-Labor","volume":"41 2","pages":"Pages 113-118"},"PeriodicalIF":0.0,"publicationDate":"2019-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.neulab.2019.04.003","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43205295","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Das Karpaltunnel-Syndrom. Anatomie - Klinik - Messmethoden","authors":"Wilhard Reuter","doi":"10.1016/j.neulab.2018.10.001","DOIUrl":"10.1016/j.neulab.2018.10.001","url":null,"abstract":"<div><p>Nach einer Darstellung der anatomischen Beziehung zwischen Nervus medianus und Karpaltunnel werden die klinischen Symptome und Untersuchungsmethoden dargestellt.</p><p>Die klassischen Methoden der Elektroneurographie werden durch die Darstellung intraindividueller Vergleichsmessungen und der Inchingmethode ergänzt.</p></div><div><p>Based on the anatomical relationship between the median nerve and the carpaltunnel the signs and symptoms of carpal tunnel syndrome are described. The demonstration of the methods of classical motor and sensory electroneurography is completed with intraindividually motor and sensory comparison studies and the “inching”-method.</p></div>","PeriodicalId":35874,"journal":{"name":"Neurophysiologie-Labor","volume":"41 1","pages":"Pages 1-12"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.neulab.2018.10.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42539147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Verstärkereingänge und Polarität","authors":"Volker Milnik","doi":"10.1016/j.neulab.2018.08.001","DOIUrl":"10.1016/j.neulab.2018.08.001","url":null,"abstract":"<div><p>In dieser Arbeit werden Begriffe wie aktiv, Referenz, different, indifferent, Anode, Kathode sowie Polaritätsverhältnisse am Eingang des Differenzverstärkers dargestellt. Fehler bei vertauschen (verpolen) der Ableit- und Stimulationselektrode werden mit Beispielen aufgezeigt. Unterschiedliche Gerätetypen mit ihren individuellen farblichen Kodierungen für die Verstärkereingänge werden ebenfalls behandelt. Testmethoden zur Polaritätsfrage bei Stimulationselektroden, Ableitkabeln und Verstärkereingängen werden anhand von Bildbeispielen gezeigt.</p></div><div><p>In this work, terms as active, reference, different, indifferent electrode, anode, cathode as well as polarity circumstances on the entry of the difference amplifier are discussed. Mistakes with exchanged derive- and stimulation electrodes are shown with examples. Different device types with their individual codings for the amplifier inputs are also handled. Test methods for checking polarity of stimulation electrodes, electrode cords and amplifier inputs are discussed and demonstrated with examples.</p></div>","PeriodicalId":35874,"journal":{"name":"Neurophysiologie-Labor","volume":"41 1","pages":"Pages 52-68"},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1016/j.neulab.2018.08.001","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44650655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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