Howard R S, Murray N M
Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
Muscle Nerve. 1992 Nov;15(11):1240-5. doi: 10.1002/mus.880151104.
The usefulness of multichannel surface recording of fasciculations was evaluated by a retrospective study of 116 patients with various neurological disorders. Eight channels of a conventional electroencephalograph were used with plate electrode recordings from the upper arms and legs. Wide-spread fasciculations (defined as five or more of the eight muscle groups) were recorded in 48 of 54 patients with motor neuron disease, spinal muscular atrophy or postpolio syndrome, but noted on routine clinical examination at presentation in only 6. Eleven of 23 patients with peripheral neuropathy or myelopathy had fasciculations in five or more leads compared to one clinically, and 3 of 39 with other neurological diseases had fasciculations electrically but in only one were they clinically observed. The method is a noninvasive and sensitive adjunct to clinical examination for detecting fasciculations. Its diagnostic value is limited by the relatively high incidence of fasciculations in neuropathies and myelopathies. However, this study suggests that "false negatives" are rare and that the diagnosis of motor neuron disease should be reconsidered when less than five leads shows fasciculations.
通过对116例患有各种神经系统疾病的患者进行回顾性研究，评估了多通道表面记录肌束震颤的实用性。使用传统脑电图仪的八个通道，通过置于上臂和腿部的平板电极进行记录。在54例运动神经元病、脊髓性肌萎缩或小儿麻痹后遗症患者中，有48例记录到广泛的肌束震颤（定义为八个肌肉群中有五个或更多出现肌束震颤），但在初次就诊时的常规临床检查中仅6例被发现。23例周围神经病或脊髓病患者中有11例在五个或更多导联记录到肌束震颤，而临床检查仅发现1例；39例患有其他神经系统疾病的患者中有3例通过电记录发现肌束震颤，但临床仅观察到1例。该方法是一种用于检测肌束震颤的非侵入性且敏感的临床检查辅助手段。其诊断价值受到周围神经病和脊髓病中肌束震颤相对较高发生率的限制。然而，本研究表明“假阴性”很少见，并且当少于五个导联出现肌束震颤时，应重新考虑运动神经元病的诊断。
