Marrero Humberto Gonzalez, Stålberg Erik V
Section of Clinical Neurophysiology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden.
Department of Clinical Neurophysiology, Section of Neuroscience, Uppsala University, Uppsala, Sweden.
Muscle Nerve. 2016 Apr;53(4):555-63. doi: 10.1002/mus.24886.
In severe acute quadriplegic myopathy in intensive care unit (ICU) patients, muscle fibers are electrically inexcitable; in critical illness polyneuropathy, the excitability remains normal. Conventional electrodiagnostic methods do not provide the means to adequately differentiate between them. In this study we aimed to further optimize the methodology for the study of critically ill ICU patients and to create a reference database in healthy controls.
Different electrophysiologic protocols were tested to find sufficiently robust and reproducible techniques for clinical diagnostic applications.
Many parameters show large test-retest variability within the same healthy subject. Reference values have been collected and described as a basis for studies of weakness in critical illness.
Using the ratio of neCMAP/dmCMAP (response from nerve and direct muscle stimulation), refractory period, and stimulus-response curves may optimize the electrodiagnostic differentiation of patients with critical illness myopathy from those with critical illness polyneuropathy.
在重症监护病房（ICU）患者的严重急性四肢瘫性肌病中，肌纤维电活动无法兴奋；在危重病性多发性神经病中，兴奋性仍正常。传统的电诊断方法无法充分区分这两种疾病。在本研究中，我们旨在进一步优化对危重症ICU患者的研究方法，并建立健康对照的参考数据库。
测试了不同的电生理方案，以找到足够稳健且可重复的技术用于临床诊断。
许多参数在同一健康受试者内显示出较大的重测变异性。已收集参考值并进行描述，作为危重病中肌无力研究的基础。
使用复合肌肉动作电位（CMAP）近端与远端比值（神经和直接肌肉刺激的反应）、不应期和刺激-反应曲线，可能会优化危重病性肌病患者与危重病性多发性神经病患者的电诊断鉴别。
