Electrophysiological Evaluation of Motor Dysfunction in Liver Cirrhotic Patients
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Liver Cirrhoses
- Sponsor
- Kasr El Aini Hospital
- Enrollment
- 56
- Locations
- 1
- Primary Endpoint
- Early detection of peripheral neuropathy among liver cirrhotic patients.
- Status
- Completed
- Last Updated
- 6 years ago
Overview
Brief Summary
cross sectional observational study, aimed to assess the electrophysiological function of the motor units in liver cirrhotic patients.
Detailed Description
Liver cirrhosis is a global health problem which could be associated with several neurological manifestations. The associated peripheral neuropathy could be assessed by conventional nerve conduction studies. Objective: The study aims at early detection of peripheral neuropathy among patients of liver cirrhosis by conventional nerve conduction studies and quantitative EMG methods. In addition, the study aims at finding out correlation between peripheral neuropathy and severity of the liver cirrhosis. Methods: This a cross-sectional study conducted on fifty-six liver cirrhotic patients, that had been recruited from the Endemic medicine department/outpatient clinics and their age-gender matched sixty-one healthy controls. The recruited patients were clinically assessed .Both conventional nerve conduction studies and quantitative EMG techniques in the form of MUNE calculation, using modified spike -triggered technique and IPA ratio evaluation were performed for the allocated cirrhotic patients.
Investigators
Reem Mahmoud Mohamed Ali Gabr
Resident of Clinical neurophysiology- Kasr alainy-Cairo University
Kasr El Aini Hospital
Eligibility Criteria
Inclusion Criteria
- •Both genders.
- •Age interval range between 18 and 60 years (To avoid maturational changes and aging process on motor unit number).
- •Liver cirrhotic patients( including compensated and decompensated patients);
- •Presenting hematemesis/melena and/or ascites.
- •Diagnosis of liver cirrhosis is confirmed by abdominal ultrasound
Exclusion Criteria
- •Patients with identifiable cause of peripheral neuropathy (e.g. diabetic patients) .
- •Patients who developed hepatocellular carcinoma (to avoid para-neoplastic syndrome e.g. peripheral neuropathy)
- •Patients with other non-hepatic chronic illness such as: patients with renal disease (to avoid other causes of metabolic neuropathies).
Outcomes
Primary Outcomes
Early detection of peripheral neuropathy among liver cirrhotic patients.
Time Frame: baseline
* Using nerve conduction studies of the: left ulnar,left posterior tibial and right deep peroneal motor nerves;assess their distal latency (measured in milliseconds) ,amplitude (measured in millivolts) and conduction velocities (measured in m/s).In addition , to sensory studies of the left ulnar and right sural sensory nerves; assessment of peak latency (measured in milliseconds) , amplitude (measured in microvolts) and their conduction velocities(measured in m/s) . * Compare the values with our normative values. * Detect evidence of peripheral neuropathy ( increased in distal latency above the upper limit of its normal value, decreased conduction velocity below the lower limit of its normal value and decreased amplitude below lower limit of its normal value). * A minimum of three variables in two or more nerves are required to diagnose polyneuropathy as referenced by (Meulstee \& Van Der Meche , 1995).
Secondary Outcomes
- Detection of correlation between neuropathy and severity of liver cirrhosis.(baseline)
- Motor unit number estimation using Spike-Triggered method.(Baseline)
- Correlation of MUNE values to fatigue(Baseline)