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Nerve conduction study of median nerve with severity of airway obstruction

Sanjeev Kumar Shrivastava, Rashmi Dave, Asha Shrivastava.




Abstract

Background: Chronic obstructive pulmonary disease (COPD) is frequently associated with significant extrapulmonary manifestations. Hypoxemia resulting in peripheral neuropathy is known to occur as a systemic manifestation of COPD.

Aims and Objectives: This study aims to analyze the abnormalities of sensory and motor component of median nerve in stable COPD patients and correlate the changes with severity of COPD, duration of disease, and pack-years.

Materials and Methods: The study comprised 60 stable COPD patients (40–50 years) with no clinical neuropathy. Duration of illness, pack-years, and spirometric indices (forced expiratory volume in 1 s % [FEV1%], FEV1/forced vital capacity, and peak expiratory flow rate %) were assessed. Electrodiagnostic study of the right and left median nerve was done using root mean square EMG MKII. Distal latency, nerve conduction velocity, and action potential (compound motor action potential [CMAP] and sensory nerve action potential [SNAP]) for median motor and sensory nerve were analyzed. COPD patients were classified on the basis of the level of airway obstruction (FEV1 >50% and FEV1< 50%) into two groups and correlation of electrodiagnostic variables of these two groups with duration of illness, pack-years, and level of airway obstruction was established.

Results: CMAP of the left median motor nerve was reduced with increasing severity of disease. Significant correlation was established with spirometric variables, quantum of smoking, and duration of illness.

Conclusion: Airway obstruction leads to changes in arterial blood gas analysis (hypoxemia, hypercapnia, and acidosis) resulting in impairment of nerve conduction.

Key words: Chronic Obstructive Pulmonary Disease; Hypoxemia; Demyelination






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