Conradi S, Grimby L, Lundemo G
Muscle Nerve. 1982 Mar;5(3):202-8. doi: 10.1002/mus.880050305.
Electromyographic potentials of fasciculations were studied in ten patients with amyotrophic lateral sclerosis (ALS). The EMG recordings were made from the extensor digitorum brevis muscle. The EMG recording was so selective that only one motor unit potential appeared on maximal voluntary effort and on supramaximal electrical stimulation of the peroneal nerve. In a series of fasciculations, the shapes of the EMG potentials varied, while in a series of voluntary twitch activations of electrical nerve stimulations the EMG potentials were mainly constant. Fasciculations were followed by antidromic impulses in the test unit axon as judged from collision tests, and they persisted after lidocaine blockades of the nerve to the muscle. The findings are compatible with a conclusion of distal multifocal triggering of fasciculation. Fasciculating motor units had voluntary firing properties close to those of normal low-threshold motor units. Widespread fasciculations were abolished by a nonparalytic dose of a synthetic curare derivative (Pavulon) and augmented by administration of neostigmine in two cases. The fasciculations in ALS thus have the same characteristics as experimental fasciculations evoked by cholinesterase inhibitors, and there is reason to believe that the underlying pathophysiological mechanism is similar in the two cases.
对10例肌萎缩侧索硬化症（ALS）患者的肌束震颤肌电图电位进行了研究。肌电图记录取自趾短伸肌。肌电图记录具有高度选择性，在最大自主用力和腓总神经超强电刺激时，仅出现一个运动单位电位。在一系列肌束震颤中，肌电图电位的形状各异，而在一系列由电神经刺激引起的自主抽搐激活中，肌电图电位基本恒定。根据碰撞试验判断，肌束震颤后测试单位轴突出现逆向冲动，且在利多卡因阻断神经至肌肉后仍持续存在。这些发现支持肌束震颤远端多灶触发的结论。出现肌束震颤的运动单位具有与正常低阈值运动单位相近的自主放电特性。在两例患者中，非麻痹剂量的合成箭毒衍生物（泮库溴铵）消除了广泛的肌束震颤，而新斯的明给药后肌束震颤增强。因此，ALS中的肌束震颤与胆碱酯酶抑制剂诱发的实验性肌束震颤具有相同的特征，有理由相信这两种情况下潜在的病理生理机制相似。
