Chen R, Remtulla H, Bolton C F
Department of Clinical Neurological Sciences, University of Western Ontario, London, Canada.
J Neurol Neurosurg Psychiatry. 1995 Apr;58(4):480-3. doi: 10.1136/jnnp.58.4.480.
This is the first reported detailed electrophysiological study of diaphragmatic myoclonus. An 86 year old woman had rapid, intermittent epigastric pulsations. Neurological examination and imaging studies of the brain and spinal cord were normal. Needle EMG showed rhythmic contractions of the diaphragm and external intercostal muscles at 4 to 5 Hz. These contractions were often associated with suppression of normal breathing and were capable of maintaining adequate ventilation. Both diaphragms were involved but showed considerable variability in their relative latencies. Automated interference pattern analysis suggested a change in recruitment order, with selective activation of large phrenic motoneurons. The supraspinal mechanisms mediating diaphragmatic myoclonus are different from that of voluntary and involuntary rhythmic breathing, and seem to be unrelated to palatal myoclonus. The generator source is likely related to respiratory centres in the rostral medulla.
这是首次报道的关于膈肌阵挛的详细电生理研究。一名86岁女性出现快速、间歇性的上腹部搏动。神经系统检查以及脑和脊髓的影像学检查均正常。针极肌电图显示膈肌和肋间外肌以4至5赫兹的频率有节律性收缩。这些收缩常伴有正常呼吸的抑制，且能够维持足够的通气。双侧膈肌均受累，但相对潜伏期存在显著差异。自动干扰模式分析提示募集顺序改变，大的膈运动神经元选择性激活。介导膈肌阵挛的脊髓上机制不同于自主和非自主节律性呼吸的机制，且似乎与腭肌阵挛无关。发生器来源可能与延髓头端的呼吸中枢有关。
