Taylor R G, Lieberman J S
Arch Phys Med Rehabil. 1980 Nov;61(11):532-6.
A syndrome of severe upper extremity pain, swelling and weakness following intraarterial injection of illicit secobarbital was evaluated in 4 patients. Although the involved muscle mass was small, serum muscle enzymes were markedly elevated. Electromyography (emg) revealed fibrillation and positive sharp wave potentials at 7 days. Motor unit action potentials were of low amplitude and of brief duration but markedly reduced in numbers, a mixture of myopathic and neuropathic changes. Motor nerve conduction velocities and latencies were normal, but M-wave amplitudes were small. Serial studies in 1 patient revealed persistent fibrillation and positive sharp waves in all involved muscles with absent voluntary contraction in the ulnar muscles and no response to stimulation of the ulnar nerve at 60 days postinjection. The emg and conduction studies for the median nerve distribution were normal except for the abnormal rest activity. A muscle biopsy (on day 66) in this patient revealed findings compatible with neuropathy, myopathy and vasculitis. The results indicate that electrodiagnostic studies may be of value for prognosis in these cases by evaluating the extent of neuromyopathic involvement.
对4例在动脉内注射非法速可巴比妥后出现严重上肢疼痛、肿胀和无力综合征的患者进行了评估。尽管受累肌肉量较小，但血清肌肉酶显著升高。肌电图（emg）在7天时显示纤颤和正锐波电位。运动单位动作电位幅度低、时程短，但数量明显减少，呈现肌病性和神经病性改变的混合表现。运动神经传导速度和潜伏期正常，但M波幅度较小。对1例患者的系列研究显示，在注射后60天时，所有受累肌肉持续存在纤颤和正锐波，尺侧肌肉无自主收缩，对尺神经刺激无反应。除静息活动异常外，正中神经分布区域的肌电图和传导研究正常。该患者的肌肉活检（第66天）显示出与神经病变、肌病和血管炎相符的结果。结果表明，通过评估神经肌肉受累程度，电诊断研究可能对这些病例的预后有价值。
