Department of Neuroscience, Clinical Neurophysiology, Uppsala University and Uppsala University Hospital, Uppsala, Sweden.
Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
Clin Neurophysiol. 2019 Jul;130(7):1091-1097. doi: 10.1016/j.clinph.2019.03.029. Epub 2019 Apr 13.
Studies on electrodiagnostic (EDX) methods usually exclude the very elderly. This also holds true for studies of normal EDX values. We analyzed the outcome and diagnostic value of EDX and collected reference data in a large cohort of patients ≥80 years of age.
Referral information, ICD-10 diagnoses and EDX data were retrieved from all patients ≥80 years of age referred for EDX studies at our department in 1995-2015. Normative data, including reference ranges, were obtained using the extrapolated norms (e-norms) method.
1966 unique patients (2335 examinations) were included. Only 11% were considered to have normal findings. 66% had pathological EDX findings in accordance with the indication for referral. Carpal tunnel syndrome was by far the most common diagnosis. Normative data retrieved using e-norms were similar to those of reference values from healthy subjects regarding EMG multiMUP data, but typically provided a wider normality window when applied to nerve conduction parameters.
EDX studies are valuable in the diagnostic work-up of very elderly patients. Using the e-norms method may be a useful alternative when obtaining reference values in this age group.
Our findings provide additional insights to the challenges of evaluating very elderly patients with neuromuscular disease and underline the importance of including this growing part of the patient population in EDX research.
电诊断（EDX）方法的研究通常排除非常高龄的患者。这同样适用于正常 EDX 值的研究。我们分析了高龄患者（≥80 岁）中大量患者的 EDX 结果和诊断价值，并收集了参考数据。
从 1995 年至 2015 年我们科室所有≥80 岁的接受 EDX 检查的患者中，检索了转介信息、ICD-10 诊断和 EDX 数据。使用外推法（e-norms）获取了正常数据，包括参考范围。
共纳入 1966 名（2335 次检查）患者。仅有 11%的患者被认为检查结果正常。66%的患者根据转介指征存在病理性 EDX 发现。腕管综合征是最常见的诊断。使用 e-norms 检索到的正常数据与健康受试者的 EMG 多 MUAP 数据的参考值相似，但应用于神经传导参数时，通常提供了更宽的正常范围。
EDX 检查对高龄患者的诊断具有重要价值。在该年龄段获取参考值时，使用 e-norms 方法可能是一种有用的替代方法。
我们的发现为评估患有神经肌肉疾病的非常高龄患者带来了新的认识，并强调了将这一不断增长的患者群体纳入 EDX 研究的重要性。
