Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Apr-Jun;13(2):77-82.
doi: 10.4103/ijabmr.ijabmr_484_22. Epub 2023 Jul 17.

Electrophysiological Study in the Right Upper and Lower Limbs in Infants with Lumbosacral Meningomyelocele and in Normal Infants: A Case-control Study

Aparna Debbarma  1 , Sarita Chowdhary  2 , Priyanka Bhagat  3
Affiliations

Electrophysiological Study in the Right Upper and Lower Limbs in Infants with Lumbosacral Meningomyelocele and in Normal Infants: A Case-control Study

Aparna Debbarma et al. Int J Appl Basic Med Res. 2023 Apr-Jun.

Abstract

Objective: The study aimed to assess the electrophysiological parameters (Hofmann reflex [H-reflex] and motor nerve conduction velocity [MNCV]) on children's upper and lower limbs with lumbosacral meningomyelocele (MMC) and age-matched control to see the effect of the MMC on the cervical segment of the spinal cord.

Materials and methods: The present study was performed on infants with lumbosacral MMC. Twenty-five infants were examined with a mean age of 50 days of either sex. Out of them, 13 infants were in control and the remaining 12 were diagnosed with MMC. The H-reflex parameter and MNCV were recorded in these children's right upper and lower limbs.

Results: H-reflex was elicited in all the control group babies. In MMC, the H-reflex was elicited in the upper limbs. However, H-reflex was not elicited in the lower limbs of a few MMC babies. The upper limb's H-reflex parameters and conduction velocity were significantly higher than those corresponding lower limbs in control babies. In MMC, where the H-reflex was elicited, such differences in the lower and upper limbs were not observed. However, the values of MNCV in the upper limb (right median nerve) were significantly less, and the values of Hmax in the lower limb (soleus muscle) were significantly more in MMC babies than in the control group.

Conclusions: The values of electrophysiological parameters were higher in the upper limbs as compared to the corresponding lower limbs in control. These values were not altered in the upper limbs than those corresponding lower limbs of MMC, suggesting that motor function development was impaired/delayed in the spinal segment cranial to MMC lesion, and motor impairment in MMC children is mostly a result of upper motor neuron dysfunction.

Keywords: Hofmann reflex; motor nerve conduction velocity; spina bifida.

PubMed Disclaimer

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Each bar depicts the mean ± SD values of Hmax (mv) of the control and MMC groups’ right upper limb and lower limbs. The asterisk (*) indicates a significant difference between the upper limb and the corresponding lower limb within group. MMC: Meningomyelocele; SD: Standard deviation; Hmax: Maximum amplitude of H-reflex
Figure 2
Figure 2
Each bar depicts the mean ± SD values of Hmax/Mmax ratio of the control and MMC groups’ right upper limb and lower limbs. The asterisk (*) indicates a significant difference between the upper limb and the corresponding lower limb within group. MMC: Meningomyelocele; Hmax: Maximum amplitude of H-reflex; Mmax: Maximum amplitude of the M-wave; SD: Standard deviation
Figure 3
Figure 3
Each bar depicts the mean ± SD values of MNCV (m/s) of the control and MMC groups’ right upper limb and lower limbs. The asterisk (*) indicates a significant difference between the upper limb and the corresponding lower limb within group. MNCV: Motor nerve conduction velocity, MMC: Meningomyelocele; SD: Standard deviation
See this image and copyright information in PMC

References

    1. Hasan KM, Eluvathingal TJ, Kramer LA, Ewing-Cobbs L, Dennis M, Fletcher JM. White matter microstructural abnormalities in children with spina bifida myelomeningocele and hydrocephalus: A diffusion tensor tractography study of the association pathways. J Magn Reson Imaging. 2008;27:700–9. - PMC - PubMed
    1. Jacobs RA, Wolfe G, Rasmuson M. Upper extremity dysfunction in children with myelomeningocele. Z Kinderchir. 1988;43(Suppl 2):19–21. - PubMed
    1. Dennis M, Salman MS, Jewell D, Hetherington R, Spiegler BJ, MacGregor DL, et al. Upper limb motor function in young adults with spina bifida and hydrocephalus. Childs Nerv Syst. 2009;25:1447–53. - PMC - PubMed
    1. Jewell D, Fletcher JM, Mahy CE, Hetherington R, MacGregor D, Drake JM, et al. Upper limb cerebellar motor function in children with spina bifida. Childs Nerv Syst. 2010;26:67–73. - PMC - PubMed
    1. Dennis M, Salman MS, Juranek J, Fletcher JM. Cerebellar motor function in spina bifida meningomyelocele. Cerebellum. 2010;9:484–98. - PMC - PubMed