Grippe Talyta, Cunha Natalia Spinola Costa da, BrandÃo Pedro Renato de Paula, Fernandez Rubens Nelson Morato, Cardoso Francisco Eduardo Costa
Centro Universitário de Brasília, Faculdade de Medicina, Brasília DF, Brazil.
Hospital de Base do Distrito Federal, Departamento de Neurologia, Brasília DF, Brazil.
Arq Neuropsiquiatr. 2020 May 29;78(8):512-522. doi: 10.1590/0004-282X20190195.
Neurophysiological studies are ancillary tools to better understand the features and nature of movement disorders. Electromyography (EMG), together with electroencephalography (EEG) and accelerometer, can be used to evaluate a hypo and hyperkinetic spectrum of movements. Specific techniques can be applied to better characterize the phenomenology, help distinguish functional from organic origin and assess the most probable site of the movement generator in the nervous system.
We intend to provide an update for clinicians on helpful neurophysiological tools to assess movement disorders in clinical practice.
Non-systematic review of the literature published up to June 2019.
A diversity of protocols was found and described. These include EMG analyses to define dystonia, myoclonus, myokymia, myorhythmia, and painful legs moving toes pattern; EMG in combination with accelerometer to study tremor; and EEG-EMG to study myoclonus. Also, indirect measures of cortical and brainstem excitability help to describe and diagnose abnormal physiology in Parkinson's disease, atypical parkinsonism, dystonia, and myoclonus.
These studies can be helpful for the diagnosis and are usually underutilized in neurological practice.
神经生理学研究是更好地理解运动障碍特征和本质的辅助工具。肌电图(EMG)与脑电图(EEG)和加速度计一起,可用于评估运动的低动力和高动力谱。可以应用特定技术来更好地表征现象学,帮助区分功能性与器质性起源,并评估运动发生器在神经系统中最可能的位置。
我们打算为临床医生提供有关在临床实践中评估运动障碍的有用神经生理学工具的最新信息。
对截至2019年6月发表的文献进行非系统性综述。
发现并描述了多种方案。这些包括用于定义肌张力障碍、肌阵挛、肌束震颤、肌节律以及下肢疼痛性移动脚趾模式的肌电图分析;肌电图与加速度计结合用于研究震颤;脑电图-肌电图用于研究肌阵挛。此外,皮质和脑干兴奋性的间接测量有助于描述和诊断帕金森病、非典型帕金森综合征、肌张力障碍和肌阵挛中的异常生理学。
这些研究有助于诊断,在神经科实践中通常未得到充分利用。