Kang D X, Fan D S
Department of Neurology, 3rd Hospital, Beijing Medical University, China.
Electromyogr Clin Neurophysiol. 1995 Jun-Jul;35(4):231-8.
Sternocleidomastoid muscle EMG (SCM-EMG) and dermatomal somatosensory evoked potential (DSSEP) were evaluated as diagnostic aids in differentiation between amyotrophic lateral sclerosis (ALS) and cervical spondylotic myelopathy (CSM) in this study. 104 inpatients were divided into three groups: those diagnosed clinically as either (A) ALS (36 cases), or (B) CSM (32 cases) and (C) those needed further investigation (36 cases). EMG of limb muscles and sternocleidomastoid of both sides in all, and of tongue muscles in 58/104 of three groups; DSSEP in 56/104 of all three groups; MRI/CTM in 12/36 of group A and all patients of group B and C. SCM-EMG abnormal in 34/36 of group A but normal in all 32 of group B. SCM-EMG also abnormal in 32/36 of group C and 8 of them showed postoperative aggravation. DSSEP normal in 12/12 of group A while abnormal in 19/20 of group B. DSSEP abnormal only in 6/24 of group C. MRI/CTM showed spinal compression in all cases presenting abnormal DSSEP and close correspondence between upper margins of pathological involvement as revealed using these two methods. Both SCM-EMG and DSSEP have proved to be valuable differential aids between ALS and CSM.
在本研究中，评估了胸锁乳突肌肌电图（SCM-EMG）和皮节体感诱发电位（DSSEP）在肌萎缩侧索硬化症（ALS）和颈椎病性脊髓病（CSM）鉴别诊断中的辅助诊断价值。104例住院患者被分为三组：临床诊断为（A）ALS的患者36例，（B）CSM的患者32例，以及（C）需要进一步检查的患者36例。所有患者均进行双侧肢体肌肉和胸锁乳突肌的肌电图检查，三组中58/104的患者进行舌肌肌电图检查；所有三组中56/104的患者进行DSSEP检查；A组12/36的患者以及B组和C组的所有患者进行MRI/CTM检查。A组34/36的患者SCM-EMG异常，而B组所有32例患者均正常。C组36例中有32例SCM-EMG也异常，其中8例术后病情加重。A组12/12的患者DSSEP正常，而B组20例中有19例异常。C组仅24例中有6例DSSEP异常。MRI/CTM显示，所有DSSEP异常的病例均有脊髓受压，并且这两种方法所显示的病理累及上缘之间具有密切对应关系。SCM-EMG和DSSEP均已被证明是ALS和CSM之间有价值的鉴别辅助手段。
