Abnormal dip phenomenon: a characteristic electrophysiological marker in interdigital neuropathy of the foot
The nerve conduction findings in interdigital neuropathy of the foot (IDN; Morton's neuroma) have rarely been reported. We analyzed the nerve conduction data in 23 patients with suspected IDN studied between 1982 and 2002. Diagnosis of IDN was made on the basis of clinical features. All patient...
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| Veröffentlicht in: | Arquivos de neuro-psiquiatria 2007-09, Vol.65 (3B), p.771-778 |
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| creator | Almeida, Diogo F de Kurokawa, Katsumi Hatanaka, Yuki Hemmi, Shoji Claussen, Gwen C Oh, Shin J |
| description | The nerve conduction findings in interdigital neuropathy of the foot (IDN; Morton's neuroma) have rarely been reported. We analyzed the nerve conduction data in 23 patients with suspected IDN studied between 1982 and 2002.
Diagnosis of IDN was made on the basis of clinical features. All patients underwent routine nerve conduction studies and a near-nerve needle sensory nerve conduction study of the interdigital nerves by Oh's method in the symptomatic foot.
Of the 23 patients, the diagnosis of definite IDN was made in 13 cases and of possible NDN in the others cases. Nineteen were females. Twenty two patients had only one nerve affected. One patient had two nerves affected. The III-IV interdigital nerve was affected in 17 cases and the II-III interdigital nerve in 7 cases. The near-nerve needle nerve conduction showed abnormality in the affected interdigital nerves in all definite IDN cases and confirmed the diagnosis of IDN in 10 cases by the abnormal dip phenomenon (a selective decrease of 50% or more in the sensory CNAP amplitude of the affected nerve compared with that of the preceding interdigital nerve). In 11 possible IDN cases, IDN was identified by the abnormal dip phenomenon.
The near-nerve needle sensory nerve conduction of the interdigital nerves is a highly sensitive diagnostic test, and abnormal dip phenomenon is the most characteristic electrophysiological marker for the diagnosis of IDN. |
| doi_str_mv | 10.1590/s0004-282x2007000500007 |
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Diagnosis of IDN was made on the basis of clinical features. All patients underwent routine nerve conduction studies and a near-nerve needle sensory nerve conduction study of the interdigital nerves by Oh's method in the symptomatic foot.
Of the 23 patients, the diagnosis of definite IDN was made in 13 cases and of possible NDN in the others cases. Nineteen were females. Twenty two patients had only one nerve affected. One patient had two nerves affected. The III-IV interdigital nerve was affected in 17 cases and the II-III interdigital nerve in 7 cases. The near-nerve needle nerve conduction showed abnormality in the affected interdigital nerves in all definite IDN cases and confirmed the diagnosis of IDN in 10 cases by the abnormal dip phenomenon (a selective decrease of 50% or more in the sensory CNAP amplitude of the affected nerve compared with that of the preceding interdigital nerve). In 11 possible IDN cases, IDN was identified by the abnormal dip phenomenon.
The near-nerve needle sensory nerve conduction of the interdigital nerves is a highly sensitive diagnostic test, and abnormal dip phenomenon is the most characteristic electrophysiological marker for the diagnosis of IDN.</description><identifier>ISSN: 0004-282X</identifier><identifier>ISSN: 1678-4227</identifier><identifier>EISSN: 0004-282X</identifier><identifier>DOI: 10.1590/s0004-282x2007000500007</identifier><identifier>PMID: 17952278</identifier><language>eng</language><publisher>Brazil: Academia Brasileira de Neurologia - ABNEURO</publisher><subject>Action Potentials ; Adolescent ; Adult ; Aged ; Electric Stimulation ; Electrophysiology ; Female ; Foot - innervation ; Humans ; Male ; Middle Aged ; Neural Conduction - physiology ; Neuroma - diagnosis ; Neuroma - physiopathology ; NEUROSCIENCES ; Peripheral Nervous System Neoplasms - diagnosis ; Peripheral Nervous System Neoplasms - physiopathology ; PSYCHIATRY ; Sensitivity and Specificity</subject><ispartof>Arquivos de neuro-psiquiatria, 2007-09, Vol.65 (3B), p.771-778</ispartof><rights>This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c430t-f8f4c9b5478f74d5e8ec293f319375507e57792ebf6130ccd86144c92c54112d3</citedby><cites>FETCH-LOGICAL-c430t-f8f4c9b5478f74d5e8ec293f319375507e57792ebf6130ccd86144c92c54112d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,860,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17952278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Almeida, Diogo F de</creatorcontrib><creatorcontrib>Kurokawa, Katsumi</creatorcontrib><creatorcontrib>Hatanaka, Yuki</creatorcontrib><creatorcontrib>Hemmi, Shoji</creatorcontrib><creatorcontrib>Claussen, Gwen C</creatorcontrib><creatorcontrib>Oh, Shin J</creatorcontrib><title>Abnormal dip phenomenon: a characteristic electrophysiological marker in interdigital neuropathy of the foot</title><title>Arquivos de neuro-psiquiatria</title><addtitle>Arq Neuropsiquiatr</addtitle><description>The nerve conduction findings in interdigital neuropathy of the foot (IDN; Morton's neuroma) have rarely been reported. We analyzed the nerve conduction data in 23 patients with suspected IDN studied between 1982 and 2002.
Diagnosis of IDN was made on the basis of clinical features. All patients underwent routine nerve conduction studies and a near-nerve needle sensory nerve conduction study of the interdigital nerves by Oh's method in the symptomatic foot.
Of the 23 patients, the diagnosis of definite IDN was made in 13 cases and of possible NDN in the others cases. Nineteen were females. Twenty two patients had only one nerve affected. One patient had two nerves affected. The III-IV interdigital nerve was affected in 17 cases and the II-III interdigital nerve in 7 cases. The near-nerve needle nerve conduction showed abnormality in the affected interdigital nerves in all definite IDN cases and confirmed the diagnosis of IDN in 10 cases by the abnormal dip phenomenon (a selective decrease of 50% or more in the sensory CNAP amplitude of the affected nerve compared with that of the preceding interdigital nerve). In 11 possible IDN cases, IDN was identified by the abnormal dip phenomenon.
The near-nerve needle sensory nerve conduction of the interdigital nerves is a highly sensitive diagnostic test, and abnormal dip phenomenon is the most characteristic electrophysiological marker for the diagnosis of IDN.</description><subject>Action Potentials</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Electric Stimulation</subject><subject>Electrophysiology</subject><subject>Female</subject><subject>Foot - innervation</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neural Conduction - physiology</subject><subject>Neuroma - diagnosis</subject><subject>Neuroma - physiopathology</subject><subject>NEUROSCIENCES</subject><subject>Peripheral Nervous System Neoplasms - diagnosis</subject><subject>Peripheral Nervous System Neoplasms - physiopathology</subject><subject>PSYCHIATRY</subject><subject>Sensitivity and Specificity</subject><issn>0004-282X</issn><issn>1678-4227</issn><issn>0004-282X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkU1LJDEQhoO4-P0XNCdvM1a-Jt3eRNxVEPawu-Ct6UlX7Gh3p03S4Px7M8yIenEhRVLJ-6SKtwg5YzBnqoSLCAByxgv-ygF0TlQO0Dvk4P3hYffTeZ8cxvgEwGVZ6j2yz3SpONfFAemuloMPfd3Rxo10bHHwfY7hktbUtHWoTcLgYnKGYocmBT-2q-h85x-dyVRfh2cM1A15ZWXjHl3K1wNOWVmndkW9palFar1Px-SHrbuIJ9v9iPz7efP3-nZ2__vX3fXV_cxIAWlmCytNuVRSF1bLRmGBhpfCClYKrRRoVFqXHJd2wQQY0xQLJjPBjZKM8UYckfnm32gcdr568lMYcsHqz9qRau3IF9sycL4BxuBfJoyp6l002HX1gH6K1aKQTHO1-K-QAxcCCshCvRGa4GMMaKsxuGzWqmJQrUf4TS-n2xLTssfmg9vOTLwBi96WGA</recordid><startdate>20070901</startdate><enddate>20070901</enddate><creator>Almeida, Diogo F de</creator><creator>Kurokawa, Katsumi</creator><creator>Hatanaka, Yuki</creator><creator>Hemmi, Shoji</creator><creator>Claussen, Gwen C</creator><creator>Oh, Shin J</creator><general>Academia Brasileira de Neurologia - ABNEURO</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TK</scope><scope>7X8</scope><scope>GPN</scope></search><sort><creationdate>20070901</creationdate><title>Abnormal dip phenomenon: a characteristic electrophysiological marker in interdigital neuropathy of the foot</title><author>Almeida, Diogo F de ; Kurokawa, Katsumi ; Hatanaka, Yuki ; Hemmi, Shoji ; Claussen, Gwen C ; Oh, Shin J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c430t-f8f4c9b5478f74d5e8ec293f319375507e57792ebf6130ccd86144c92c54112d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Action Potentials</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Electric Stimulation</topic><topic>Electrophysiology</topic><topic>Female</topic><topic>Foot - innervation</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neural Conduction - physiology</topic><topic>Neuroma - diagnosis</topic><topic>Neuroma - physiopathology</topic><topic>NEUROSCIENCES</topic><topic>Peripheral Nervous System Neoplasms - diagnosis</topic><topic>Peripheral Nervous System Neoplasms - physiopathology</topic><topic>PSYCHIATRY</topic><topic>Sensitivity and Specificity</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Almeida, Diogo F de</creatorcontrib><creatorcontrib>Kurokawa, Katsumi</creatorcontrib><creatorcontrib>Hatanaka, Yuki</creatorcontrib><creatorcontrib>Hemmi, Shoji</creatorcontrib><creatorcontrib>Claussen, Gwen C</creatorcontrib><creatorcontrib>Oh, Shin J</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Neurosciences Abstracts</collection><collection>MEDLINE - Academic</collection><collection>SciELO</collection><jtitle>Arquivos de neuro-psiquiatria</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Almeida, Diogo F de</au><au>Kurokawa, Katsumi</au><au>Hatanaka, Yuki</au><au>Hemmi, Shoji</au><au>Claussen, Gwen C</au><au>Oh, Shin J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Abnormal dip phenomenon: a characteristic electrophysiological marker in interdigital neuropathy of the foot</atitle><jtitle>Arquivos de neuro-psiquiatria</jtitle><addtitle>Arq Neuropsiquiatr</addtitle><date>2007-09-01</date><risdate>2007</risdate><volume>65</volume><issue>3B</issue><spage>771</spage><epage>778</epage><pages>771-778</pages><issn>0004-282X</issn><issn>1678-4227</issn><eissn>0004-282X</eissn><abstract>The nerve conduction findings in interdigital neuropathy of the foot (IDN; Morton's neuroma) have rarely been reported. We analyzed the nerve conduction data in 23 patients with suspected IDN studied between 1982 and 2002.
Diagnosis of IDN was made on the basis of clinical features. All patients underwent routine nerve conduction studies and a near-nerve needle sensory nerve conduction study of the interdigital nerves by Oh's method in the symptomatic foot.
Of the 23 patients, the diagnosis of definite IDN was made in 13 cases and of possible NDN in the others cases. Nineteen were females. Twenty two patients had only one nerve affected. One patient had two nerves affected. The III-IV interdigital nerve was affected in 17 cases and the II-III interdigital nerve in 7 cases. The near-nerve needle nerve conduction showed abnormality in the affected interdigital nerves in all definite IDN cases and confirmed the diagnosis of IDN in 10 cases by the abnormal dip phenomenon (a selective decrease of 50% or more in the sensory CNAP amplitude of the affected nerve compared with that of the preceding interdigital nerve). In 11 possible IDN cases, IDN was identified by the abnormal dip phenomenon.
The near-nerve needle sensory nerve conduction of the interdigital nerves is a highly sensitive diagnostic test, and abnormal dip phenomenon is the most characteristic electrophysiological marker for the diagnosis of IDN.</abstract><cop>Brazil</cop><pub>Academia Brasileira de Neurologia - ABNEURO</pub><pmid>17952278</pmid><doi>10.1590/s0004-282x2007000500007</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Action Potentials Adolescent Adult Aged Electric Stimulation Electrophysiology Female Foot - innervation Humans Male Middle Aged Neural Conduction - physiology Neuroma - diagnosis Neuroma - physiopathology NEUROSCIENCES Peripheral Nervous System Neoplasms - diagnosis Peripheral Nervous System Neoplasms - physiopathology PSYCHIATRY Sensitivity and Specificity |
| title | Abnormal dip phenomenon: a characteristic electrophysiological marker in interdigital neuropathy of the foot |
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