This document discusses electrodiagnosis in pediatrics. It notes that peripheral nerve myelination begins around 15 weeks of gestation and continues until ages 3-5. Nerve conduction studies in infants have slower velocities than adults that reach adult values by ages 3-5. Electromyography in infants has lower motor unit amplitudes and shorter durations compared to adults. Specific clinical problems that can be evaluated with electrodiagnosis in pediatrics include spinal cord injuries, brachial plexus injuries, and cervical nerve root lesions. Stimulating and recording electrodes must be appropriately sized for pediatric patients.
این پاورپوینت در کارگاه ارزیابی و توانبخشی مشکلات راه رفتن در کودکان مبتلا به فلج مغزی توسط دکتر محمد خیاط زاده ارائه شده است.
برای مطالعه مطالب بیشتر در این زمینه به وب سایت فروردین مراجعه کنید.
www.farvardin-group.com
Post Polio Residual Palsy: Pathophysiology & Principles of RxAnisuddin Bhatti
Prof. Anisuddin Bhatti, Paeds Orthop Surgeon delivered lecture on Post Polio paralysis and deformities Part 1 on Pathophysio and principles of treatment, through Dr. Ziauddin University Hospital Clifton Karachi webinar on googel.meet, on 3rd April 2021. Acknowledge for material taken from Research papers, slideshare and books as referred in reference list.
این پاورپوینت در کارگاه ارزیابی و توانبخشی مشکلات راه رفتن در کودکان مبتلا به فلج مغزی توسط دکتر محمد خیاط زاده ارائه شده است.
برای مطالعه مطالب بیشتر در این زمینه به وب سایت فروردین مراجعه کنید.
www.farvardin-group.com
Post Polio Residual Palsy: Pathophysiology & Principles of RxAnisuddin Bhatti
Prof. Anisuddin Bhatti, Paeds Orthop Surgeon delivered lecture on Post Polio paralysis and deformities Part 1 on Pathophysio and principles of treatment, through Dr. Ziauddin University Hospital Clifton Karachi webinar on googel.meet, on 3rd April 2021. Acknowledge for material taken from Research papers, slideshare and books as referred in reference list.
Surgical Versus Ponseti Approach for the Management of CTEV - Dr. CHINTAN N. ...DrChintan Patel
Surgical Versus Ponseti Approach for the Management of CTEV (congenital tallipes equino varus): A Comparative Study (J Pediatr Orthop Volume 33, Number 3, April/May 2013)
Deformities observed with Pes cavus includes :
*clawing of the toes
*posterior hind foot deformity (described as an increased calcaneal angle)
*contracture of the plantar fascia
*cock-up deformity of the great toe
Following References were used to prepare this powerpoint presentation which makes the slides accurate and relaible for studying purpose; Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
Slides includes following headings;
DEFINITION
TYPES
ORTHOPAEDIC ASSESSMENT
MEDICAL MANAGGEMENT
PHYSIOTHERAPY MANAGEMENT
SURGICAL MANAGEMENT
Comprises of assessment and diagnostic techniques of neurodynamics.
it includes both the mechnaical interface and neurological aspect, along with the level of application of diagnostic as well as treatment part of neurodynamics
این پاورپوینت در کارگاه ارزیابی و توانبخشی مشکلات راه رفتن در کودکان مبتلا به فلج مغزی توسط دکتر محمد خیاط زاده ماهانی، عضو هیات علمی دانشگاه جندی شاپور اهواز در محل دانشگاه بهزیستی ارائه شده است.
برای مشاهده مطالب بیشتر در این زمینه به وب سایت فروردین مراجعه نمایید.
www.farvardin.com
what is crouch gait and its Physiotherapy rehabilitation
this type gait mostly seen in spastic diaplegic Cerebral palsy child least common in quadriplegic C P , and hemiplegic C P
Surgical Versus Ponseti Approach for the Management of CTEV - Dr. CHINTAN N. ...DrChintan Patel
Surgical Versus Ponseti Approach for the Management of CTEV (congenital tallipes equino varus): A Comparative Study (J Pediatr Orthop Volume 33, Number 3, April/May 2013)
Deformities observed with Pes cavus includes :
*clawing of the toes
*posterior hind foot deformity (described as an increased calcaneal angle)
*contracture of the plantar fascia
*cock-up deformity of the great toe
Following References were used to prepare this powerpoint presentation which makes the slides accurate and relaible for studying purpose; Therapeutic Exrercise – Carolyn Kisner
Orthopaedic Physical Assessment – Magee
Orthopaedic Medicine – L. Ombregt
Campbell’s Operative Orthopaedics
Slides includes following headings;
DEFINITION
TYPES
ORTHOPAEDIC ASSESSMENT
MEDICAL MANAGGEMENT
PHYSIOTHERAPY MANAGEMENT
SURGICAL MANAGEMENT
Comprises of assessment and diagnostic techniques of neurodynamics.
it includes both the mechnaical interface and neurological aspect, along with the level of application of diagnostic as well as treatment part of neurodynamics
این پاورپوینت در کارگاه ارزیابی و توانبخشی مشکلات راه رفتن در کودکان مبتلا به فلج مغزی توسط دکتر محمد خیاط زاده ماهانی، عضو هیات علمی دانشگاه جندی شاپور اهواز در محل دانشگاه بهزیستی ارائه شده است.
برای مشاهده مطالب بیشتر در این زمینه به وب سایت فروردین مراجعه نمایید.
www.farvardin.com
what is crouch gait and its Physiotherapy rehabilitation
this type gait mostly seen in spastic diaplegic Cerebral palsy child least common in quadriplegic C P , and hemiplegic C P
NCS are done by placing electrodes on the skin and stimulating the nerves through electrical impulses. To study motor nerves, electrodes are placed over a muscle that receives its innervation from the nerve you want to test (stimulate).
The presentation contains the information (From standard reference books mentioned in last slide) regarding evoked potentials which are commonly performed including BERA,VEP,SSEP etc.
Similar to 13- Electrodiagnosis in pedriatrics (DPT-9).pptx (20)
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
2. MATURATIONAL FACTORS
IN PEDIATRIC ELECTRODIAGNOSIS
Peripheral nerve myelination begins at about the
15th week of gestation and continues throughout
the first 3–5 years after birth
Conduction velocities are determined by
myelination, diameter of the fiber, and internodal
differences.
The diameter of the fibers at the time of birth has
been shown to be one-half of that in the adult.
The nodes of Ranvier continue to remodel, with
peak internodal distances being reached at 5 years
of age
3. 1. NERVE CONDUCTION STUDIES
Normal standard adult values for
conduction velocities are reached by age 3
to 5. In infancy, upper and lower extremity
conduction velocities are similar under age 1
Faster conductions are maintained in the
upper extremities and comparatively slower
conductions in the lower extremities, as
with adults. Unique values for expected
conduction velocities are observed for
specific peripheral nerves
4. CONT.
a. Motor Nerve Conduction
Motor conduction velocities in infants are found to be one-
half of adult values. In infants, conduction studies should
be at least greater than 20 m/s. At birth, motor conduction
velocity (MCVs) for the median, ulnar, and peroneal nerves
are 27 m/s.
b. Distal Motor Latency
Distal motor latencies (DMLs) show maturational changes
between infancy and 3–5 years of age, similar to motor
conduction velocities
5. CONT.
c. Compound Muscle Action Potential
Compound muscle action potential (CMAP)
amplitudes are important to consider in the
evaluation of axonal loss, conduction block, and
muscle fiber atrophy
d. Sensory Nerve Conduction
Modern EMG equipment, which includes amplifiers
and signal averaging capability, allows sensory nerve
action potentials to be routinely recorded in the
absence of peripheral nerve pathology
6. CONT.
e. F-waves
The F-wave is a late response that appears as a
supermaximal motor nerve stimulation and arises
from the discharge of a small number of motor
neurons in response to antidromic stimulation of
the motor axon. The F-wave latency is measured
from hand and foot intrinsic muscles, and is useful
for evaluating the motor nerve conduction velocity
and proximal nerve segments.
7. 2. ELECTROMYOGRAPHY
a. Motor Unit Configuration and Amplitude
Amplitudes of motor unit action potentials (MUAPs)
are lower in infants, with amplitudes ranging from
150 microvolts to approximately 2,000 microvolts
b. Motor Unit Duration
Infantile motor unit action potentials are often
shorter in duration. Durations of motor unit action
potentials are often shorter than 5 milliseconds in
infants
8. CONT.
c. In general, as strength of voluntary
contraction increases, there is an increase in
motor unit action potentials recruited.
However, the recruitment pattern in infants
may be disordered and chaotic.
9. STIMULATING ELECTRODES
For neonates and young infants, small stimulators with
short interelectrode distances are commercially
available and simplify the testing of short nerve
segments over small extremities
The stimulation intensity may be reduced by the use of
a small monopolar needle electrode as the stimulating
cathode, with a more proximal surface anode in close
proximity.
Generally, a standard bipolar stimulator may be utilized
for children 6 months of age and older.
10.
11. RECORDING ELECTRODES
Sensory Conduction
Generally, sensory nerve action potentials are easily
recorded in newborns. The standard ring electrodes,
needle recording electrodes, and/or pediatric-size finger-
clip electrodes may be used.
Motor Conduction
Generally, standard 6-mm silver disc surface electrodes
are used as active and reference electrodes for motor
conduction studies.
12.
13. SPECIFIC CLINICAL PROBLEMS IN
PEDIATRIC ELECTRODIAGNOSIS
Spinal Cord Injury
Neonatal spinal cord injury may occur as an obstetrical complication
or as a result of a vascular insult to the spinal cord.
Typical clinical presentation may include findings of diffuse
hypotonia, possible respiratory distress, hyporeflexia, and urinary
retention.
An anterolateral spinal cord injury due to a vascular insult will
produce EMG findings of severe denervation in diffuse myotomes.
Typically, two to three weeks may lapse before fibrillations and
positive sharp waves are elicited.
Anterior horn cell and axonal degeneration will typically result in
decreased CMAP amplitudes in multiple peripheral nerves.
14. CONT.
Somatosensory evoked potentials SSEPs may help establish a
sensory level in an infant or young child with spinal cord injury,
and is also useful in the evaluation of the comatose or obtunded
child at risk for spinal cord injury without radiographic
abnormality (SCIWORA)
Brachial Plexus and Cervical Nerve Root Lesions
Traumatic obstetrical brachial plexopathy usually results from
traction on the brachial plexus (predominantly upper trunk) and
its associated spinal roots.This can lead to stretching or rupture
of the trunks of the plexus and/or partial axonotmesis or
avulsion of the spinal roots.
15. CONT.
Injury to the upper trunk of the brachial plexus and/or
C5–6 cervical roots is the more common injury known
as Duchenne-Erb’s palsy.
Damage to the lower trunk and/or C8–T1 cervical roots
is referred to as Klumpke’s palsy.
Severe brachial plexus injuries may involve the entire
plexus and C5–T1 nerve roots diffusely.
A Horner’s syndrome due to injury of the C8 andT1
roots and the superior cervical sympathetic ganglion
may be an associated clinical finding.
16. CONT.
Examination should be deferred until at least
three to four weeks after the injury to allow for
abnormal spontaneous rest activity (fibrillations
and positive sharp waves) to develop in the setting
of denervation and axon loss.
Complete injuries are characterized
electromyographically by absent MUAPs (Motor
Unit Action Potential) and absent CMAP
(Compound Muscle Action Potential) amplitudes
in peripheral nerves supplied by the transected
axons.
17. CONT.
The preservation of the CMAP amplitude 10 days or
more after the injury with complete clinical paralysis
suggests that the damage is, in part, a neuropraxic
injury with better prognosis
In perinatal traumatic brachial plexopathy, positive
sharp waves and fibrillations, indicative of true
denervation, can be found by 14 to 21 days after
injury
Absence of fibrillations or positive sharp waves after
this time frame suggests a neuropraxic lesion with
intact axons. In this setting, the prognosis for
recovery is favorable.