Proposal of a New Criterion for Electrodiagnosis of Meralgia Paresthetica by Evoked Potentials

We examined 19 subjects with meralgia paresthetica (bilateral in three cases), recording bilateral somatosensory-evoked potentials (SSEPs) after stimulation of the tibial posterior nerve (TPN) and cutaneous stimulation in the region of the lateral femoral cutaneous nerve (LFCN). We calculated the difference between TPN SSEPs and LFCN SSEPs cortical potentials, identifying a temporal parameter that we termed D(SEP). We defined D(SEP) normal values in a control group. D(SEP) evaluation showed good sensitivity and specificity (85.7% and 82.4%, respectively; accuracy, 83.3%) in discriminating affected limbs from unaffected. The main advantage of this method is to disengage from the necessity of contralateral comparison of LFCN recordings, joined with a reduction of interindividual variability of LFCN SSEPs amplitude and latency that often causes a lower sensitivity of other methods. As an interesting consideration, D(SEP) evaluation appears to mark out a possible subclinical involvement of LFCN in the asymptomatic side of patients with meralgia paresthetica.

Sporadic amyotrophic lateral sclerosis as an infectious disease: A possible role of cyanobacteria?

The available epidemiological data for amyotrophic lateral sclerosis (ALS) support an infectious etiology and lead us to propose a new hypothesis. We examined older epidemiological data concerning categories of the population with increased incidence (aged people, people living in rural areas, farmers, breeders), more recent epidemiological reports regarding Italian soccer players, AIDS patients, people living in highly polluted areas, and reports of cases of conjugal and pregnancy-associated ALS. The toxic and infectious hypotheses lead us to suggest a role for cyanobacteria in the production of endogenous beta-N-methylamino-L-alanine. Infection from a cyanobacterium, or another ubiquitous bacterium having similar characteristics, may be the missing clue to the etiology of ALS. We speculate that ubiquitous bacteria secreting toxic amino acids and "colonizing" tissues and organs in the human body might be the common element linking motor neuron diseases in Guam to sporadic ALS in the rest of the world.