Trojan D A, Gendron D, Cashman N R
Department of Neurology, Montreal Neurological Institute and Hospital, Quebec, Canada.
Orthopedics. 1991 Dec;14(12):1353-61. doi: 10.3928/0147-7447-19911201-11.
Post-poliomyelitis syndrome refers to new symptoms that may occur years after recovery from poliomyelitis. The most common of these symptoms are new weakness, fatigue, and pain. This article describes electrodiagnostic studies--conventional electromyography (EMG), single fiber electromyography (SFEMG), and macroelectromyography (macro-EMG)--that have provided information on the post-polio motor unit and on the possible etiology of some post-polio syndrome symptoms. Muscular fatigue, and indirectly, general fatigue, may be due to neuromuscular junction transmission defects in some post-polio individuals, as suggested by reduction of the compound motor action potentials on repetitive stimulation, and increased jitter and blocking on SFEMG. Progressive weakness and atrophy in post-polio syndrome is probably due to a distal degeneration of post-polio motor units with resultant irreversible muscle fiber denervation. Electrodiagnostic evidence of ongoing denervation includes fibrillation and fasciculation potentials on conventional EMG, increased jitter and blocking on SFEMG, and smaller macro-EMG amplitudes in newly weakened post-polio muscles. However, even though electrodiagnostic studies have provided insight into the possible causes of some post-polio syndrome symptoms, no specific electrodiagnostic test for the syndrome is currently available.
小儿麻痹后遗症是指小儿麻痹症恢复多年后可能出现的新症状。这些症状中最常见的是新出现的无力、疲劳和疼痛。本文介绍了电诊断研究——传统肌电图（EMG）、单纤维肌电图（SFEMG）和巨肌电图（macro - EMG）——这些研究提供了有关小儿麻痹后运动单位以及某些小儿麻痹后遗症症状可能病因的信息。肌肉疲劳，以及间接导致的全身疲劳，在一些小儿麻痹后遗症患者中可能是由于神经肌肉接头传递缺陷所致，这可通过重复刺激时复合运动动作电位降低以及SFEMG上的抖动增加和阻滞来提示。小儿麻痹后遗症中的进行性无力和萎缩可能是由于小儿麻痹后运动单位的远端变性，导致不可逆的肌纤维失神经支配。正在发生失神经支配的电诊断证据包括传统EMG上的纤颤和束颤电位、SFEMG上的抖动增加和阻滞，以及小儿麻痹后新出现无力的肌肉中巨肌电图振幅减小。然而，尽管电诊断研究为某些小儿麻痹后遗症症状的可能原因提供了见解，但目前尚无针对该综合征的特异性电诊断测试。
