Grana E A, Kraft G H
Department of Rehabilitation Medicine, University of Washington, Seattle.
Arch Phys Med Rehabil. 1994 Jul;75(7):778-82.
Prospective electrodiagnostic studies were performed in 26 subjects with definite multiple sclerosis (MS), ranging from mildly to severely affected, to evaluate possible lower motor neuron involvement. Ten of these subjects also underwent single fiber electromyography (SFEMG) examination. Nerve conduction studies (NCS) were normal with no evidence of peripheral or entrapment neuropathies. Abnormal late responses with increased amplitude and chronodispersion of F-waves were found in 9 subjects. Abnormal recruitment patterns with decreased numbers of motor unit action potentials (MUAPs) of normal amplitude, phasicity, and firing rate were found in 9 subjects. Five of them also presented spontaneous electromyographic (EMG) activity in several muscles with no specific myotomal or peripheral nerve distribution. SFEMG showed increased jitter with no blocking in 4 of the 10 subjects studied. Thus, EMG abnormalities were present in many MS patients with no concurrent peripheral or entrapment neuropathies. Electromyographers must be aware of these abnormalities when performing routine EMG examinations in these patients.
对26例确诊为多发性硬化症(MS)的患者进行了前瞻性电诊断研究,这些患者病情从轻度到重度不等,以评估可能存在的下运动神经元受累情况。其中10名患者还接受了单纤维肌电图(SFEMG)检查。神经传导研究(NCS)结果正常,没有外周或卡压性神经病变的证据。9名患者出现F波幅度增加和时限离散的异常迟发反应。9名患者出现募集模式异常,正常幅度、位相和发放频率的运动单位动作电位(MUAPs)数量减少。其中5名患者还在几块肌肉中出现了自发性肌电图(EMG)活动,无特定的肌节或周围神经分布。在10名接受研究的患者中,有4名患者的SFEMG显示抖动增加但无阻滞现象。因此,许多MS患者存在EMG异常,且无并发的外周或卡压性神经病变。在对这些患者进行常规EMG检查时,肌电图检查人员必须意识到这些异常情况。