Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Department of Neurology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Clin Neurophysiol. 2020 Dec;131(12):2804-2808. doi: 10.1016/j.clinph.2020.08.021. Epub 2020 Oct 1.
To examine differences in fasciculation distribution between patients with multifocal motor neuropathy (MMN) and amyotrophic lateral sclerosis (ALS) based on muscle ultrasound.
Forty-one muscles (tongue muscle and 40 muscles of the trunk and limbs on both sides) in 5 MMN patients and 21 muscles (tongue muscle and 20 muscles on the onset side) in 21 ALS patients were subjected to muscle ultrasound individually for 60 seconds to detect the presence of fasciculations.
Fasciculation detection rates on the onset side were significantly higher in ALS (42.4 ± 18.3%, mean ± SD) than in MMN (21.9 ± 8.8%) patients (p < 0.05). In MMN patients, no fasciculation was detected in the tongue or truncal muscles. There was no difference in the fasciculation detection rate between the onset and non-onset sides or between upper and lower limbs in MMN patients.
In MMN patients, fasciculations were detected extensively in the limbs. However, the detection rate in patients with MMN was lower than in those with ALS.
Demonstration of the absence of fasciculations in the tongue and truncal muscles in MMN patients by extensive muscle ultrasound examination may help distinguish MMN from ALS.
基于肌肉超声检查，研究多灶性运动神经病（MMN）和肌萎缩侧索硬化症（ALS）患者的肌束震颤分布差异。
对 5 例 MMN 患者的 41 块肌肉（舌肌和双侧躯干及四肢的 40 块肌肉）和 21 例 ALS 患者的 21 块肌肉（舌肌和发病侧的 20 块肌肉）分别进行 60 秒的肌肉超声检查，以检测肌束震颤的存在。
ALS（42.4±18.3%，均值±标准差）患者发病侧的肌束震颤检出率显著高于 MMN（21.9±8.8%）患者（p<0.05）。MMN 患者的舌肌和躯干肌肉均未检测到肌束震颤。MMN 患者的发病侧和非发病侧、上肢和下肢之间的肌束震颤检出率无差异。
在 MMN 患者中，肌束震颤广泛存在于四肢。然而，MMN 患者的检出率低于 ALS 患者。
通过广泛的肌肉超声检查，证明 MMN 患者的舌肌和躯干肌肉无肌束震颤，这有助于将 MMN 与 ALS 区分开来。
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