Clinical And High-resolution Ultrasonography Features Of Neuropathic Pain

Part ? Clinical and Abnormal Ultrasonography features of Neuropathic painObjective : To explore the clinical and ultrasound characteristics of patients with neuropathic pain and to further understand neuropathic pain.Methods:1.The demographic characteristics,clinical data and the ultrasonic characteristics of135 patients with neuropathic pain were collected.The ultrasonic results were collected and compared with the normal reference values of peripheral nerves established by Ultrasound Room of the Department of Neurology,Affiliated Hospital of Guizhou Medical University.2.135 patients were divided into light,medium and heavy according to the degree of pain and divided into acute and chronic.According to age,they were divided into youth group,middle age group and older-age group.According to the limb of pain,they were divided into three groups: single limb pain,double limb pain and upper and lower limbs pain.According to the results of ultrasonic,it divided into obscuring of the epineurium,the cross-sectional area thickening group,the echo abnormal group and the compression group.Chi square test was used to analyze the difference in the distribution of age,duration,and degree of pain and abnormal description of nerve in 135 patients.3.57 patients with single limb pain were divided into three groups: normal group,one limb abnormal group and two limb abnormal group according to ultrasonic findings.The differences between the three groups were also analyzed.Results:1.There were no statistically significant differences in the distribution of gender,age,duration,and degree of pain.2.Numbness,prickling,burning pain were the most common neuropathic pain symptoms in the 135 patients.3.The ultrasonic characteristics abnormal peripheral nerves mainly focused on obscuring of the epineurium of the patients with neuropathic pain.The abnormal ultrasonic of peripheral nerves of patients with singlelimb pain were manifestation in two limbs.Conclusion: The peripheral nerve abnormalities mainly focused on obscuring of the epineurium and the peripheral nerves of ipsilateral limb and contralateral limb without pain were abnormal ultrasonography of the patients with single limb pain.Part ? Study of the ultrasonic scoring in asymmetric neuropathic painObjective:To analyze the characteristics peripheral nerve injury of the patients with asymmetrical neuropathic pain and establish a DCEC scoring method and determine the threshold by high frequency ultrasound.Methods: 1.The demographic characteristics,clinical data,nerve conduction,and ultrasound results of peripheral nerveof of 40 patients with asymmetric neuropathic pain were collected and analyzed.The results of nerve conduction and ultrasound were compared with the reference value of normal nerve conduction and peripheral nerve established by the Electrophysiologyical Center and Ultrasound Room of the Department of Neurology Affiliated Hospital of Guizhou Medical University.2.The definition(D),cross-section area(C),the echogenicity(E)and with or without compression(C)of each nerve of the ipsilateral and contralateral side were scored and the diagnostic value and threshold value were determined by the ROC curve analysis.3.40 patients with asymmetrical neuropathic pain were divided into normal group and abnormal group of nerve conduction studies according to the results of nerve conduction studies on both sides of the limbs.They were divided into the ipsilateral and contralateral side according to the pain location.The differences between the normal group and the abnormal group of nerve conduction studies,the ipsilateral and contralateral side were analyzed.Results : 1.There were no statistically significant differences in the distribution of gender and age between normal group and abnormal group,but there was difference in the duration of disease.2.The DCEC ultrasound score has certain diagnostic value in judging the peripheral nerve injury of the patients with asymmetrical neuropathic pain.A reliable boundary value of the ipsilateral and contralateral could be defined at 5.5 points and 2.5.3.The ultrasound scores of the ipsilateral and contralateral limb were statistically significant both in 40 patients with asymmetric neuropathic pain and those with abnormal nerve conduction.Conclusion:The DCEC score has a value for the assessment of the degree of nerve injury in patients with asymmetry neuropathic pain.Using ROC curve analysis boundary values for ipsilateral and contralateral limb were defined.The score of the ipsilateralis higher than the contralateral limb.