Date Elaine S, Kim Byung-Jo, Yoon Joon Shik, Park Byung Kyu
Division of Physical Medicine and Rehabilitation, Stanford School of Medicine, Stanford, California, USA.
Muscle Nerve. 2006 Sep;34(3):361-4. doi: 10.1002/mus.20557.
Paraspinal fibrillation potentials or positive sharp waves (PSWs) reportedly may be the only electrodiagnostic abnormality in patients with radiculopathies. However, spontaneous activity may be present in muscles of asymptomatic subjects. To determine whether abnormal spontaneous activity in the cervical paraspinal muscles is clinically relevant, we evaluated the prevalence of such activity in asymptomatic individuals and examined its relationship with age. Sixty-six asymptomatic subjects underwent a needle electromyographic examination of the paraspinal muscles bilaterally at the C5/6 and C6/7 levels. All of the recorded potentials were captured and their firing rates and waveforms were evaluated. The potentials were considered to be abnormal if reproducible trains of PSWs or fibrillation potentials were present. Eight of the 66 (12%) subjects showed PSWs, five bilaterally; none showed fibrillation potentials. A statistical analysis for the effect of age could not be performed due to the small sample size. Because electromyographic cervical paraspinal abnormalities can be found in asymptomatic subjects, caution should be exercised when attributing the etiology of neck pain to radiculopathy if the only electrodiagnostic findings are electromyographic cervical paraspinal abnormalities.
据报道,椎旁肌纤颤电位或正锐波(PSW)可能是神经根病患者唯一的电诊断异常。然而,无症状受试者的肌肉中也可能出现自发活动。为了确定颈段椎旁肌异常自发活动是否具有临床相关性,我们评估了无症状个体中此类活动的发生率,并研究了其与年龄的关系。66名无症状受试者接受了双侧C5/6和C6/7水平的椎旁肌针电极肌电图检查。记录所有电位,并评估其发放频率和波形。如果出现可重复的PSW或纤颤电位序列,则认为电位异常。66名受试者中有8名(12%)出现PSW,5名双侧出现;无人出现纤颤电位。由于样本量小,无法进行年龄效应的统计分析。因为在无症状受试者中可发现肌电图颈段椎旁肌异常,所以如果唯一的电诊断结果是肌电图颈段椎旁肌异常,在将颈部疼痛的病因归因于神经根病时应谨慎。