title: Neurophysiologic analysis of neuromuscular symptoms in UK Gulf War veterans: a controlled study.
abstract: 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.
authors.affiliation: Gulf War Illness Research Unit, Guy's, King's, and St. Thomas' School of Medicine, London, UK. m.k.sharief@kcl.ac.uk
authors.forename: M K
authors.initials: MK
authors.lastname: Sharief
authors.forename: J
authors.initials: J
authors.lastname: Priddin
authors.forename: R S
authors.initials: RS
authors.lastname: Delamont
authors.forename: C
authors.initials: C
authors.lastname: Unwin
authors.forename: M R
authors.initials: MR
authors.lastname: Rose
authors.forename: A
authors.initials: A
authors.lastname: David
authors.forename: S
authors.initials: S
authors.lastname: Wessely
mesh_terms: 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