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肌电图在马神经肌肉运动问题临床诊断中的作用。

The role of electromyography in clinical diagnosis of neuromuscular locomotor problems in the horse.

作者信息

Wijnberg I D, Back W, de Jong M, Zuidhof M C, van den Belt A J M, van der Kolk J H

机构信息

Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12-16, 3584 TD, Utrecht, The Netherlands.

出版信息

Equine Vet J. 2004 Dec;36(8):718-22. doi: 10.2746/0425164044848019.

Abstract

REASONS FOR PERFORMING STUDY

Systematically performed EMG needle examination of muscles provides essential information about the functional aspects of the motor unit. However, clinical studies in which information is given on the diagnostic and discriminative values of electromyography (EMG) in the horse are scarce.

OBJECTIVES

To determine to what extent inclusion of EMG analysis in clinical examination contributes to determination of type and localisation of abnormality.

METHODS

EMG analysis, complete clinical examination and diagnosis of 108 horses (mean +/- s.d. age 75 +/- 3.8 years; bodyweight 548 +/- 86 kg; height 1.67 +/- 0.07 m) were performed, and results without and with EMG analysis compared.

RESULTS

Without EMG, myopathy and neuropathy were diagnosed in 20 and 58 horses, respectively, and with EMG in 17 and 82 horses. EMG changed localisation in myopathy and neuropathy in 12 and 37% of cases, respectively. Lesions in the C1-T2, T2-L3 and L3-S3 segments were, respectively, diagnosed without EMG in 7, 11 and 30%, and with EMG in 27, 7 and 17% of cases. Where no clinical diagnosis could be made prior to EMG, many patients appeared to be suffering from localised cervical lesions (29%) or generalised neuropathy (54%).

CONCLUSIONS AND POTENTIAL RELEVANCE

The assistance of EMG in discriminating between normal, neuropathy and myopathy, and in locating pathology, contributes to diagnosis of neuromuscular problems.

摘要

开展本研究的原因

对肌肉进行系统的肌电图针极检查可提供有关运动单位功能方面的重要信息。然而,关于肌电图(EMG)在马匹中的诊断和鉴别价值的临床研究却很少。

目的

确定在临床检查中纳入肌电图分析在多大程度上有助于确定异常的类型和定位。

方法

对108匹马(平均年龄±标准差75±3.8岁;体重548±86千克;身高1.67±0.07米)进行肌电图分析、全面的临床检查和诊断,并比较有无肌电图分析时的结果。

结果

在未进行肌电图检查时,分别诊断出20匹马患有肌病和58匹马患有神经病;进行肌电图检查后,分别诊断出17匹马患有肌病和82匹马患有神经病。肌电图分别在12%的肌病病例和37%的神经病病例中改变了病变的定位。在C1 - T2、T2 - L3和L3 - S3节段的病变,在未进行肌电图检查时分别有7%、11%和30%的病例被诊断出来,而在进行肌电图检查后分别有27%、7%和17%的病例被诊断出来。在进行肌电图检查之前无法做出临床诊断的情况下,许多患者似乎患有局部颈椎病变(29%)或全身性神经病(54%)。

结论及潜在意义

肌电图在区分正常、神经病和肌病以及定位病变方面的辅助作用有助于神经肌肉问题的诊断。

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