Method and apparatus for self-diagnostic evaluation of nerve sensory latency

• US 6,553,245 B1
• Filed: 11/02/2000
• Issued: 04/22/2003
• Est. Priority Date: 11/02/2000
• Status: Expired due to Fees

• Current Assignee: Lawrence J. Grace, Richard J. Enroth
• Original Assignee: Lawrence J. Grace, Richard J. Enroth
• Inventors: Enroth, Richard J., Grace, Lawrence J.
• Primary Examiner(s): Walberg, Teresa
• Assistant Examiner(s): DAHBOUR, HENRY
• Application Number:
  US09/706,455
• Time in Patent Office: 901 Days
• Field of Search: 600/375, 600/372, 600/382, 600/384, 600/386, 600/546, 600/547, 600/554
• US Class Current: 600/375
• CPC Class Codes: A61B 5/05 Detecting, measuring or recording for diagnosis by means of electric currents or magnetic fields; Measuring using microwaves or radio waves impedance plethysmography A61B5/0295; measuring movement of the entire body or parts thereof A61B5/11; detecting, measuring or recording bioelectric or biomagnetic signals of the body or parts thereof A61B5/24
• CPC Class Codes: A61B 5/1106 to assess neuromuscular blockade, e.g. to estimate depth of anaesthesia
• CPC Class Codes: A61B 5/4041 Evaluating nerves condition
• CPC Class Codes: A61B 5/6826 Finger
• CPC Class Codes: A61B 5/6838 Clamps or clips

Abstract

A portable apparatus which allows a user to perform self-diagnostic evaluation of nerve sensory latency between a pair of epidermal locations proximal to nerve conduction paths. The device provides a simple and low-cost self-diagnostic apparatus which may be used for the detection and ongoing monitoring of sensory latency, such as sensory latency which is the result of carpal tunnel syndrome. The apparatus is powered by a single battery which provides power to all circuitry of the apparatus. Upon power activation, the device generates a series of high voltage stimulus pulses at an electrode in epidermal contact with the user/operator. The nerve response voltage is detected by a second electrode located along nerve pathway and the time delay between stimulus and response is displayed and periodically updated as each new response is detected.

Claims

1. An apparatus for self-diagnostic evaluation of nerve sensory latency between a first and second location on a user, comprising:

(a) a stimulator configured for epidermal contact with the user at said first location and for generating periodic voltage pulses of sufficient amplitude to stimulate a nerve for conduction to said second location;

(b) a detector configured for epidermal contact with the user at said second location and for detecting the stimulation of said nerve in response to a pulse from said stimulator; and

(c) means for displaying an elapsed time interval between the generation of the voltage pulse at said first location and the detection of the nerve response at said second location.

2. An apparatus as recited in claim 1, wherein said means for displaying said elapsed time interval comprises:

(a) a timer circuit configured for registering said elapsed time interval as a pulse count value, wherein the time interval commences with activation of the stimulator and ends with detection of nerve response at said second location;

(b) a display decoder configured for converting the registered pulse count value from said timer circuit to a decimal value for display; and

(c) a display configured for visually displaying said decimal value as received from said display decoder.

3. An apparatus for self-diagnostic evaluation of nerve sensory latency between a first and second contact position on a user, comprising:

(a) means for generating a voltage pulse at a first contact position of said user at a selected time, wherein said voltage pulse is of sufficient amplitude to activate a nerve pathway underlying said first and second contact positions;

(b) means for measuring the time interval between generation of the voltage pulse at said first contact position and the nerve response to said voltage pulse at said second contact position; and

(c) means for displaying the time interval received from said means for measuring.

4. An apparatus as recited in claim 3, wherein said means for generating a voltage pulse at said first contact position comprises:

(a) a power supply having an output voltage of sufficient amplitude to stimulate a nerve running between said first and said second contact positions;

(b) a switching device operatively connected to the output of said power supply and capable of delivering voltage pulses at said selected time; and

(c) an electrode configured for operatively coupling said voltage pulses to a nerve pathway at said first contact position.

5. An apparatus as recited in claim 3, wherein said means for measuring the time interval comprises a counter circuit operatively coupled to an oscillator, wherein the counter circuit begins counting pulses from the oscillator upon generation of said voltage pulse at said first contact position, and wherein the counter circuit terminates counting pulses at a pulse count value upon arrival of the nerve response at said second contact position.

6. An apparatus as recited in claim 3, wherein the means for displaying the time interval comprises:

(a) a decoder circuit configured for decoding a pulse count value received from said means for measuring; and

(b) a display device configured for displaying said time interval as represented by a decoded pulse count value received from the decoder circuit.

7. An apparatus for self-diagnostic evaluation of nerve sensory latency, such as that which is symptomatic of carpal tunnel syndrome, comprising:

(a) a power source;

(b) a stimulator circuit configured for coupling to a first electrode at a first contact position on the skin of the user and for generating an electrical stimulus pulse from said power source at a selectable time;

(c) a sense circuit configured for coupling to a second electrode at a second contact position on the skin of the user and for detecting the nerve response associated with the electrical pulse generated by the stimulator circuit as it arrives proximal to said second contact position;

(d) a counter circuit configured for recording the time interval between the generation of the electrical stimulus pulse by the stimulator circuit and detection of the arrival of the electrical stimulus pulse by the sense circuit, said counter circuit operatively coupled to an oscillator, wherein said counter circuit begins counting pulses from said oscillator upon generation of said electrical stimulus pulse at said first contact position, and wherein said counter circuit terminates counting said pulses from said oscillator upon arrival of the nerve response proximal to said second contact position, wherein the resulting pulse count represents said time interval; and

(e) a display circuit operatively coupled to said counter circuit and configured for displaying the time interval as recorded by said counter circuit.

8. An apparatus as recited in claim 7, wherein said power source comprises a single battery.

9. An apparatus as recited in claim 8, further comprising voltage regulation circuitry coupled to said power source and configured for generating intermediate voltages for use within said circuits.

10. An apparatus as recited in claim 7, wherein the stimulator circuit converts voltage provided by the power source to a sufficiently high voltage that said pulse can be properly coupled to the nerves within a nearby nerve pathway and registered by the sense circuit.

11. An apparatus as recited in claim 10, further comprising a charge pump circuit for incrementally converting the voltage provided by the power source to a high-voltage as stored on an output capacitor.

12. An apparatus as recited in claim 11, further comprising a transformer for converting the voltage which is stored on the output capacitor to a maximum peak voltage of around 200 volts.

13. An apparatus as recited in claim 7, wherein during the period of time that the power source is activated, the stimulator circuit generates a continuing series of electrical stimulus pulses.

14. An apparatus as recited in claim 7, wherein a pulse count value is loaded into the display circuit in response to detection of the arrival of the electrical stimulus pulse by said sense circuit, and wherein said counter circuit is reset upon generation of a subsequent electrical stimulus pulse.

15. An apparatus as recited in claim 14, wherein the display circuit comprises a liquid crystal display driven by an output stage of the counter circuit that also provides a phase signal utilized within the driver circuit for display segment driving.

16. An apparatus as recited in claim 14, wherein transition of a high-order intermediate output stage of the counter circuit provides a trigger signal which activates the stimulator circuit.

17. An apparatus as recited in claim 14, wherein an intermediate output stage of the counter circuit provides a second oscillator signal for the stimulator circuit, that in combination with the periodic pulses from the oscillator circuit provides the signal phases for operating a charge pump within the stimulator circuit so as to create a voltage of sufficient amplitude to properly drive the output of the stimulator upon being triggered.

18. An apparatus as recited in claim 7, further comprising a peak detector within the sense circuit which detects the peak of the associated pulse response signal such that noise immunity is improved over sensing performed with a fixed threshold.

19. An apparatus for self-diagnostic evaluation of nerve sensory latency between a first and second location on a user, comprising:

(a) a stimulator configured for epidermal contact with said user at said first location and for generating periodic voltage pulses of sufficient amplitude to stimulate a nerve for conduction to said second location;

(b) a detector configured for epidermal contact with the user at said second location and for detecting the stimulation of said nerve in response to a pulse from said stimulator;

(c) a timer circuit configured for registering, as a pulse count value, an elapsed time interval between the generation of the voltage pulse at said first location and the detection of the nerve response at said second location, wherein the time interval commences with activation of the stimulator and ends with detection of nerve response at said second location,

(d) a display decoder configured for converting the registered pulse count from said timer circuit to a decimal value for display; and

(e) a display configured for visually displaying said decimal value as received from said display decoder.

20. An apparatus for self-diagnostic evaluation of nerve sensory latency between a first and second contact position on a user, comprising:

(a) means for generating a voltage pulse at said first contact position of said user at a selected time, wherein said voltage pulse is of sufficient amplitude to activate a nerve pathway underlying said first and second contact positions;

(b) a counter circuit operatively coupled to an oscillator, wherein the counter circuit begins counting pulses from the oscillator upon generation of said voltage pulse at said first contact position, and wherein the counter circuit terminates counting pulses at a pulse count value upon arrival of the nerve response at said second contact position, said pulse count value representing the time interval between generation of said voltage pulse at said first contact position and the nerve response to said voltage pulse at said second contact position; and

(c) means for displaying said time interval.

21. An apparatus for self-diagnostic evaluation of nerve sensory latency between a first and second contact position on a user, comprising:

(a) means for generating a voltage pulse at said first contact position of said user at a selected time, wherein said voltage pulse is of sufficient amplitude to activate a nerve pathway underlying said first and second contact positions;

(b) elapsed time measuring means for measuring the time interval between generation of the voltage pulse at said first contact position and the nerve response to said voltage pulse at said second contact position, and for generating a pulse count value representing said time interval;

(c) a decoder circuit configured for decoding a pulse count value received from said elapsed time measuring means; and

(d) a display device configured for displaying elapsed time represented by a decoded pulse count value received from the decoder circuit.

22. An apparatus for self-diagnostic evaluation of nerve sensory latency, such as that which is symptomatic of carpal tunnel syndrome, comprising:

(a) a power source comprising a single battery;

(b) a stimulator circuit configured for coupling to a first electrode at a first contact position on the skin of the user and for generating an electrical pulse from said power source at a selectable time;

(c) a sense circuit configured for coupling to a second electrode at a second contact position on the skin of the user and for detecting the nerve response associated with the electrical pulse generated by the stimulator circuit as it arrives proximal to said second contact position;

(d) a timer circuit configured for recording the time interval between the generation of the electrical pulse by the stimulator circuit and the arrival of the pulse response within the sense circuit;

(e) a display circuit operatively coupled to said timer and configured for displaying the time interval as recorded by the timer circuit; and

(f) voltage regulation circuitry coupled to said power source and configured for generating intermediate voltages for use within said circuits.

23. An apparatus as recited in claim 22, wherein the stimulator circuit converts voltage provided by the power source to a sufficiently high voltage that said pulse can be properly coupled to the nerves within a nearby nerve pathway and registered by the sense circuit.

24. An apparatus as recited in claim 23, further comprising a charge pump circuit for incrementally converting the voltage provided by the power source to a high-voltage as stored on an output capacitor.

25. An apparatus as recited in claim 24, further comprising a transformer for converting the voltage which is stored on the output capacitor to a maximum peak voltage of around 200 volts.

26. An apparatus as recited in claim 22, wherein during the period of time that the power source is activated, the stimulator circuit generates a continuing series of electrical stimulus pulses.

27. An apparatus as recited in claim 22, wherein the timer circuit comprises a counter circuit receiving periodic pulses from an oscillator which modify a count value, the count value being loaded into the display in response to detecting the arrival of the stimulus pulse at the sensor circuit, and said counter being reset upon generation of a subsequent stimulus pulse.

28. An apparatus as recited in claim 27, wherein the display circuit comprises a liquid crystal display driven by an output stage of the counter circuit that also provides a phase signal utilized within the driver circuit for display segment driving.

29. An apparatus as recited in claim 27, wherein transition of a high-order intermediate output stage of the counter circuit provides a trigger signal which activates the stimulator circuit.

30. An apparatus as recited in claim 27, wherein an intermediate output stage of the counter circuit provides a second oscillator signal for the stimulator circuit, that in combination with the periodic pulses from the oscillator circuit provides the signal phases for operating a charge pump within the stimulator circuit so as to create a voltage of sufficient amplitude to properly drive the output of the stimulator upon being triggered.

31. An apparatus as recited in claim 22, further comprising a peak detector within the sense circuit which detects the peak of the associated pulse response signal such that noise immunity is improved over sensing performed with a fixed threshold.

32. An apparatus for self-diagnostic evaluation of nerve sensory latency, such as that which is symptomatic of carpal tunnel syndrome, comprising:

(a) a power source;

(b) a stimulator circuit configured for coupling to a first electrode at a first contact position on the skin of the user and for generating an electrical pulse from said power source at a selectable time;

(c) a sense circuit configured for coupling to a second electrode at a second contact position on the skin of the user and for detecting the nerve response associated with the electrical pulse generated by the stimulator circuit as it arrives proximal to said second contact position;

(d) a timer circuit configured for recording the time interval between the generation of the electrical pulse by the stimulator circuit and the arrival of the pulse response within the sense circuit; and

(e) a display circuit operatively coupled to said timer and configured for displaying the time interval as recorded by the timer circuit;

(f) wherein the stimulator circuit converts voltage provided by the power source to a sufficiently high voltage that said pulse can be properly coupled to the nerves within a nearby nerve pathway and registered by the sense circuit.

33. An apparatus as recited in claim 32, wherein said power source comprises a single battery.

34. An apparatus as recited in claim 33, further comprising voltage regulation circuitry coupled to said power source and configured for generating intermediate voltages for use within the circuitry.

35. An apparatus as recited in claim 32, further comprising a charge pump circuit for incrementally converting the voltage provided by the power source to a high-voltage as stored on an output capacitor.

36. An apparatus as recited in claim 35, further comprising a transformer for converting the voltage which is stored on the output capacitor to a maximum peak voltage of around 200 volts.

37. An apparatus as recited in claim 32, wherein during the period of time that the power source is activated, the stimulator circuit generates a continuing series of electrical stimulus pulses.

38. An apparatus as recited in claim 32, wherein the timer circuit comprises a counter circuit receiving periodic pulses from an oscillator which modify a count value, the count value being loaded into the display in response to detecting the arrival of the stimulus pulse at the sensor circuit, and said counter being reset upon generation of a subsequent stimulus pulse.

39. An apparatus as recited in claim 38, wherein the display circuit comprises a liquid crystal display driven by an output stage of the counter circuit that also provides a phase signal utilized within the driver circuit for display segment driving.

40. An apparatus as recited in claim 38, wherein transition of a high-order intermediate output stage of the counter circuit provides a trigger signal which activates the stimulator circuit.

41. An apparatus as recited in claim 38, wherein an intermediate output stage of the counter circuit provides a second oscillator signal for the stimulator circuit, that in combination with the periodic pulses from the oscillator circuit provides the signal phases for operating a charge pump within the stimulator circuit so as to create a voltage of sufficient amplitude to properly drive the output of the stimulator upon being triggered.

42. An apparatus as recited in claim 32, further comprising a peak detector within the sense circuit which detects the peak of the associated pulse response signal such that noise immunity is improved over sensing performed with a fixed threshold.

43. An apparatus for self-diagnostic evaluation of nerve sensory latency, such as that which is symptomatic of carpal tunnel syndrome, comprising:

(a) a power source,

(b) a stimulator circuit configured for coupling to a first electrode at a first contact position on the skin of the user and for generating an electrical stimulus pulse from said power source at a selectable time;

(c) a sense circuit configured for coupling to a second electrode at a second contact position on the skin of the user and for detecting the nerve response associated with the electrical stimulus pulse generated by the stimulator circuit as it arrives proximal to said second contact position;

(d) a timer circuit configured for recording the time interval between the generation of the electrical stimulus pulse by the stimulator circuit and detection of the arrival of said electrical stimulus pulse by the sense circuit; and

(e) a display circuit operatively coupled to said timer and configured for displaying the time interval as recorded by the timer circuit;

(f) wherein the timer circuit comprises a counter circuit configured to receive periodic pulses from an oscillator which modify a count value, the count value being loaded into the display circuit in response to detection of the arrival of the electrical stimulus pulse by said sense circuit, and wherein said counter is reset upon generation of a subsequent electrical stimulus pulse.

44. An apparatus as recited in claim 43, wherein said power source comprises a single battery.

45. An apparatus as recited in claim 44, further comprising voltage regulation circuitry coupled to said power source and configured for generating intermediate voltages for use within the circuitry.

46. An apparatus as recited in claim 43, wherein the stimulator circuit converts voltage provided by the power source to a sufficiently high voltage that said pulse can be properly coupled to the nerves within a nearby nerve pathway and registered by the sense circuit.

47. An apparatus as recited in claim 46, further comprising a charge pump circuit for incrementally converting the voltage provided by the power source to a high-voltage as stored on an output capacitor.

48. An apparatus as recited in claim 47, further comprising a transformer for converting the voltage which is stored on the output capacitor to a maximum peak voltage of around 200 volts.

49. An apparatus as recited in claim 43, wherein during the period of time that the power source is activated, the stimulator circuit generates a continuing series of electrical stimulus pulses.

50. An apparatus as recited in claim 43, wherein the display circuit comprises a liquid crystal display driven by an output stage of the counter circuit that also provides a phase signal utilized within the driver circuit for display segment driving.

51. An apparatus as recited in claim 43, wherein transition of a high-order intermediate output stage of the counter circuit provides a trigger signal which activates the stimulator circuit.

52. An apparatus as recited in claim 43, wherein an intermediate output stage of the counter circuit provides a second oscillator signal for the stimulator circuit, that in combination with the periodic pulses from the oscillator circuit provides the signal phases for operating a charge pump within the stimulator circuit so as to create a voltage of sufficient amplitude to properly drive the output of the stimulator upon being triggered.

53. An apparatus as recited in claim 43, further comprising a peak detector within the sense circuit which detects the peak of the associated pulse response signal such that noise immunity is improved over sensing performed with a fixed threshold.

54. A method of user self-diagnostic evaluation of nerve sensory latency along a nerve pathway between a first and second position on a user, comprising:

generating periodic stimulus pulses at a sufficiently high voltage level so as to be operatively coupled to said nerve pathway at a first position on the epidermis of the user;

detecting the arrival of a nerve response to each stimulus pulse at a second position on the epidermis of the user;

measuring the time interval for nerve conduction to occur between stimulus pulse transmittal at said first position and nerve response arrival at said second position; and

updating a display with the measured time interval for nerve conduction;

wherein the high voltage of the stimulus pulses is generated by charge pumping the voltage onto a capacitor connected with a transformer.