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Ultrasonographic Evaluation of the Median and Sciatic Nerves in Hemiplegic Patients After Stroke

Uğurlu, Fatma Gülçin MD; Tiftik, Tülay MD; Kara, Murat MD; Türkkan, Canan MD; Ersöz, Murat MD; Akkuş, Selami MD; Özçakar, Levent MD

American Journal of Physical Medicine & Rehabilitation: June 2015 - Volume 94 - Issue 6 - p 429–435
doi: 10.1097/PHM.0000000000000207
Original Research Articles

Objective The aim of this study was to evaluate morphologically and electrophysiologically the peripheral nerves of hemiplegic patients.

Design Thirty-three (18 women and 15 men) stroke patients were recruited. The mean (SD) age was 55.6 (11.3) yrs, and the mean (SD) disease duration was 14.2 (16.0) mos. Motor nerve conduction study of the median, ulnar, fibular, and tibial nerves as well as sensory nerve conduction study of the median, ulnar, and sural nerves were performed. Diameters and cross-sectional area (CSA) measurements of the median (wrist/midarm levels) and sciatic nerves (midthigh level) were acquired using a 7- to 12-MHz linear probe. The values of the nonparetic limbs were taken as controls.

Results Prolonged distal latency and slowed motor conduction velocity of the tibial nerve as well as reduced amplitudes of the median and ulnar nerves were observed on the paretic sides when compared with those of the nonparetic sides (all P < 0.05). The median and sciatic nerve cross-sectional area values were found to be smaller on the paretic sides when compared with the nonparetic sides (all P < 0.05). The median and ulnar nerve compound muscle action potential amplitudes (paretic side) were positively correlated with arm/hand Brunnstrom Motor Recovery Stage, disease duration, motor Functional Independence Measure score, and Functional Ambulation Category.

Conclusions The peripheral nerves of stroke patients seem to be affected—morphologically and electrophysiologically—on the paretic side.

From the Ankara Physical and Rehabilitation Medicine Training and Research Hospital (FGU, TT, MK, CT, ME); Department of Physical and Rehabilitation Medicine, Yıldırım Beyazıt University Medical School (SA); and Department of Physical and Rehabilitation Medicine, Hacettepe University Medical School, Ankara, Turkey (LÖ).

All correspondence and requests for reprints should be addressed to: Tülay Tiftik, MD, Ankara Fizik Tedavi ve Rehabilitasyon Eğitim ve Araştırma Hastanesi, Türkocağı sok, Sıhhıye, Ankara, 06410 Turkey.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

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