Palmer J B, Holloway A M, Tanaka E
Division of Rehabilitation Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
Arch Phys Med Rehabil. 1991 Mar;72(3):214-8.
This study assessed the utility of clinical electromyography (EMG) for detecting lower motor neuron (LMN) or upper motor neuron (UMN) dysfunction affecting the intrinsic muscles of the larynx and pharynx. Twenty-nine subjects were examined; their clinical diagnoses included perioperative nerve injury, cerebral infarction, and lateral medullary infarction. Resting activity, motor unit action potential (MUAP) morphology, and MUAP recruitment were evaluated in every case. Medical records (excluding EMG data) were analyzed for clinical evidence of LMN or UMN dysfunction in the intrinsic muscles of the larynx and pharynx. The diagnosis of LMN dysfunction rested on clinical data consistent with cranial nerve injury, poliomyelitis, Wallenberg syndrome, or unilateral bulbar palsy. Criteria for UMN dysfunction included previous cerebral (not brainstem) infarction or mass lesion or the presence of hemiparesis. Electromyographic abnormalities were significantly associated with LMN dysfunction (p less than .05), but they were not significantly associated with UMN dysfunction. Of the parameters tested, MUAP recruitment was the most sensitive (82%) and specific (92%).
本研究评估了临床肌电图（EMG）在检测影响喉和咽固有肌的下运动神经元（LMN）或上运动神经元（UMN）功能障碍方面的效用。对29名受试者进行了检查；他们的临床诊断包括围手术期神经损伤、脑梗死和延髓外侧梗死。对每个病例评估静息活动、运动单位动作电位（MUAP）形态和MUAP募集情况。分析病历（不包括肌电图数据）以寻找喉和咽固有肌LMN或UMN功能障碍的临床证据。LMN功能障碍的诊断基于与颅神经损伤、脊髓灰质炎、瓦伦贝格综合征或单侧延髓麻痹相符的临床数据。UMN功能障碍的标准包括既往脑（非脑干）梗死或占位性病变或存在偏瘫。肌电图异常与LMN功能障碍显著相关（p小于0.05），但与UMN功能障碍无显著相关性。在所测试的参数中，MUAP募集最为敏感（82%）和特异（92%）。
