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EUROPEAN JOURNAL OF PHYSICAL AND REHABILITATION MEDICINE

A Journal on Physical Medicine and Rehabilitation after Pathological Events


Official Journal of the Italian Society of Physical and Rehabilitation Medicine (SIMFER), European Society of Physical and Rehabilitation Medicine (ESPRM), European Union of Medical Specialists - Physical and Rehabilitation Medicine Section (UEMS-PRM), Mediterranean Forum of Physical and Rehabilitation Medicine (MFPRM), Hellenic Society of Physical and Rehabilitation Medicine (EEFIAP)
In association with International Society of Physical and Rehabilitation Medicine (ISPRM)
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Europa Medicophysica 2000 June;35(2):55-60

Copyright © 2000 EDIZIONI MINERVA MEDICA

language: English

Electrophysiological evaluation of the peripheral and central pathways in patients with achondroplasia before and during a lower-limb lenghtening procedure

Polo A. 1, Zambito A. 2, Antoniazzi F. 3, Simeone M. 3, Aldegheri R. 4

1 Department of Neurological and Visual Sciences, University of Verona, Italy; 2 Division of Orthopaedic Rehabilitation, University of Verona, Italy; 3 Department of Paediatrics, University of Verona, Italy; 4 Institute of Orthopaedics, University of Verona, Italy


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In ­this ­paper we ­review the spec­trum of spi­nal and periph­er­al ­nerve involve­ment sec­on­dary to achon­dro­pla­sia. Alongside con­ven­tion­al and com­pu­ter­ised imag­ing tech­niques, elec­tro­phys­io­log­i­cal inves­ti­ga­tion may rep­re­sent a use­ful, non-inva­sive ­approach in ­this clin­i­cal set­ting. Somatosensory ­evoked poten­tials (SEPs) and mag­net­ic stim­u­la­tion are val­u­able ­tools for stud­y­ing spi­nal ­cord func­tion. Neurophysio-logical abnor­mal­ities ­show a ­good cor­re­la­tion ­with the ­lesion lev­el. Imaging tech­niques indi­cate ­that mul­ti­ple mal­for­ma­tion can ­affect the ­patient at the ­same ­time and SEPs ­help to deter­mine the ­main ­site of involve­ment. Interestingly, ­these tech­niques are ­more sen­si­tive ­than clin­i­cal eval­u­a­tion in doc­u­ment­ing neu­ro­log­i­cal impair­ment in ­patients ­with achon­dro­pla­sia ­prior to the man­i­fes­ta­tion of unmis­tak­able ­signs. Callotasi has ­became a wide­ly ­used and accept­ed pro­ce­dure for ­limb length­en­ing. Extensive length­en­ing can be safe­ly per­formed in ­patients ­with achon­dro­pla­sia ­once neu­ro­log­i­cal impair­ment has ­been ­ruled out. In our expe­ri­ence, the pres­ence of elec­tro­phys­io­log­i­cal abnor­mal­ities ­calls for a com­pre­hen­sive sur­gi­cal re-eval­u­a­tion of the tra­di­tion­al pro­ce­dure, and some­times exclu­sion of ­patients. Peripheral ­nerve involve­ment may ­occur dur­ing ­limb length­en­ing, and con­tin­u­ous ­nerve mon­i­tor­ing pro­vides use­ful ­insights ­into the pathoph­y­sio­lo­gy of ­nerve dam­age.

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