肌阵挛：电生理诊断
Myoclonus: An Electrophysiological Diagnosis.
作者信息
Merchant Shabbir Hussain I, Vial-Undurraga Felipe, Leodori Giorgio, van Gerpen Jay A, Hallett Mark
机构信息
Department of Neurology Medical University of South Carolina Charleston South Carolina USA.
Facultad de Medicina Clínica Alemana Universidad del Desarrollo Santiago Chile.
出版信息
Mov Disord Clin Pract. 2020 Jun 17;7(5):489-499. doi: 10.1002/mdc3.12986. eCollection 2020 Jul.
BACKGROUND
Many different movement disorders have similar "jerk-like" phenomenology and can be misconstrued as myoclonus. Different types of myoclonus also share similar phenomenological characteristics that can be difficult to distinguish solely based on clinical exam. However, they have distinctive physiologic characteristics that can help refine categorization of jerk-like movements.
OBJECTIVES
In this review, we briefly summarize the clinical, physiologic, and pathophysiologic characteristics of different types of myoclonus. The methodology and technical considerations for the electrophysiologic assessment of jerk-like movements are reviewed. A simplistic pragmatic approach for the classification of myoclonus and other jerk-like movements based on objective electrophysiologic characteristics is proposed.
CONCLUSIONS
Clinical neurophysiology is an underutilized tool in the diagnosis and treatment of movement disorders. Various jerk-like movements have distinguishing physiologic characteristics, differentiated in the milliseconds range, which is beyond human capacity. We argue that the categorization of movement disorders as myoclonus can be refined based on objective physiology that can have important prognostic and therapeutic implications.
背景
许多不同的运动障碍具有相似的“抽搐样”表现，可能被误诊为肌阵挛。不同类型的肌阵挛也具有相似的现象学特征，仅根据临床检查难以区分。然而，它们具有独特的生理特征，有助于完善对抽搐样运动的分类。
目的
在本综述中，我们简要总结不同类型肌阵挛的临床、生理和病理生理特征。回顾了对抽搐样运动进行电生理评估的方法和技术要点。提出了一种基于客观电生理特征对肌阵挛和其他抽搐样运动进行分类的简单实用方法。
结论
临床神经生理学在运动障碍的诊断和治疗中是一种未得到充分利用的工具。各种抽搐样运动具有在毫秒范围内区分的独特生理特征，这超出了人类的能力范围。我们认为，基于客观生理学对运动障碍进行肌阵挛分类可以得到完善，这可能具有重要的预后和治疗意义。
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