Neurophysiologic analysis of neuromuscular symptoms in UK Gulf War veterans: a controlled study.
BACKGROUND
UK veterans who were deployed to the Gulf in 1990 to 1991 reported higher prevalence of neuromuscular symptoms.


OBJECTIVE
To investigate whether these Gulf War-related symptoms were associated with objective evidence of neuromuscular dysfunction.


METHODS
Forty-nine Gulf War veterans with more than four neuromuscular symptoms (Gulf-ill), 26 Gulf-well veterans, 13 symptomatic Bosnian veterans (Bosnia-ill), and 22 symptomatic veterans who were not deployed to the Gulf (Era-ill) underwent detailed neurophysiologic assessment: nerve conduction studies, quantitative sensory and autonomic testing, and concentric needle and single-fiber electromyography (EMG).


RESULTS
Nerve conduction studies detected carpal tunnel syndrome in two Gulf-ill, two Gulf-well, one Bosnia-ill, and three Era-ill veterans. Ulnar neuropathy was detected in one Gulf-ill and two Era-ill veterans. However, results of detailed nerve conduction studies of the Gulf-ill veterans were comparable with results observed in the other three groups. Quantitative sensory and autonomic assessments also failed to show any specific abnormalities in the Gulf-ill group. Similarly, quantitative assessment of concentric needle and single-fiber EMG detected no chronic denervation or myopathic changes or any abnormalities of neuromuscular transmission in the Gulf-ill veterans.


CONCLUSIONS
Gulf War-related neuromuscular symptoms are not associated with specific impairments of peripheral nerves, neuromuscular junctions, or skeletal muscles.
Sharief
M K
MK
Gulf War Illness Research Unit, Guy's, King's, and St. Thomas' School of Medicine, London, UK. m.k.sharief@kcl.ac.uk
Priddin
J
J
Delamont
R S
RS
Unwin
C
C
Rose
M R
MR
David
A
A
Wessely
S
S
D000328:Adult; D001341:Autonomic Nervous System / Q000502:physiology; D004576:Electromyography; D005260:Female; D006801:Humans; D008297:Male; D018485:Muscle Fibers, Skeletal / Q000502:physiology; D009431:Neural Conduction / Q000502:physiology; D009460:Neurologic Examination; D009468:Neuromuscular Diseases / Q000453:epidemiology* / Q000503:physiopathology; D018923:Persian Gulf Syndrome / Q000453:epidemiology* / Q000503:physiopathology; D011984:Sensory Receptor Cells / Q000502:physiology; D012684:Sensory Thresholds / Q000502:physiology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014728:Veterans