电生理测试有助于肌阵挛的诊断和分型。
Electrophysiologic testing aids diagnosis and subtyping of myoclonus.
机构信息
From the Department of Neurology (R.Z., J.W.E., J.C.v.Z., J.H.v.d.H., C.M.R., J.M.G., M.A.J.T.), University Medical Center Groningen, University of Groningen, the Netherlands; and Neuroscience and Mental Health Research Institute (K.J.P.), Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, UK.
出版信息
Neurology. 2018 Feb 20;90(8):e647-e657. doi: 10.1212/WNL.0000000000004996. Epub 2018 Jan 19.
OBJECTIVE
To determine the contribution of electrophysiologic testing in the diagnosis and anatomical classification of myoclonus.
METHODS
Participants with a clinical diagnosis of myoclonus were prospectively recruited, each undergoing a videotaped clinical examination and battery of electrophysiologic tests. The diagnosis of myoclonus and its subtype was reviewed after 6 months in the context of the electrophysiologic findings and specialist review of the videotaped clinical examination.
RESULTS
Seventy-two patients with myoclonus were recruited. Initial clinical anatomical classification included 25 patients with cortical myoclonus, 7 with subcortical myoclonus, 2 with spinal myoclonus, and 15 with functional myoclonic jerks. In 23 cases, clinical anatomical classification was not possible because of the complexity of the movement disorder. Electrophysiologic testing was completed in 66, with agreement of myoclonus in 60 (91%) and its subtype in 28 (47%) cases. Subsequent clinical review by a movement disorder specialist agreed with the electrophysiologic findings in 52 of 60; in the remaining 8, electrophysiologic testing was inconclusive.
CONCLUSIONS
Electrophysiologic testing is an important additional tool in the diagnosis and anatomical classification of myoclonus, also aiding in decision-making regarding therapeutic management. Further development of testing criteria is necessary to optimize its use in clinical practice.
目的
确定电生理测试在肌阵挛的诊断和解剖分类中的作用。
方法
前瞻性招募有临床肌阵挛诊断的参与者，每位参与者均接受视频临床检查和一系列电生理测试。在电生理发现和视频临床检查的专家审查的背景下，在 6 个月后审查肌阵挛及其亚型的诊断。
结果
共招募了 72 例肌阵挛患者。初始临床解剖分类包括 25 例皮质肌阵挛、7 例皮质下肌阵挛、2 例脊髓肌阵挛和 15 例功能性肌阵挛性抽搐。在 23 例中，由于运动障碍的复杂性，无法进行临床解剖分类。完成了 66 例电生理测试，60 例（91%）患者肌阵挛和 28 例（47%）患者肌阵挛亚型得到了一致的结果。随后由运动障碍专家进行的临床审查与 52 例中的电生理发现一致；在其余 8 例中，电生理测试结果不确定。
结论
电生理测试是肌阵挛诊断和解剖分类的重要附加工具，也有助于治疗管理决策。需要进一步制定测试标准，以优化其在临床实践中的应用。
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