Valldeoriola F, Valls-Solé J, Tolosa E S, Marti M J
Departament de Medicina, Universitat de Barcelona, Spain.
Mov Disord. 1995 Sep;10(5):550-5. doi: 10.1002/mds.870100504.
Anal sphincter electromyography may contribute to the differential diagnosis between Parkinson's disease (PD) and other parkinsonisms featuring autonomic dysfunction, such as multiple system atrophy (MSA). Although patients with progressive supranuclear palsy (PSP) do not normally exhibit clinical signs of autonomic dysfunction, a few may be first seen with urinary and fecal incontinence. We performed an electromyographic study of the anal sphincter in 12 patients with clinical criteria of probable or definite PSP, two of them with clinical manifestations of vesical and anal sphincter dysfunction. The results have been compared with those obtained from six patients with PD and six patients with MSA. An abnormal anal sphincter examination was present in five of 12 PSP patients (41.6%). The abnormal motor units of these patients were indistinguishable from those observed in patients with MSA. Patients with MSA had the largest, and patients with PD had the lowest, proportion of abnormal motor units. We conclude that some patients with PSP may have electromyographic signs of denervation in the anal sphincter, which make them indistinguishable by using this test alone from patients with MSA.
肛门括约肌肌电图检查可能有助于帕金森病（PD）与其他伴有自主神经功能障碍的帕金森综合征（如多系统萎缩，MSA）之间的鉴别诊断。虽然进行性核上性麻痹（PSP）患者通常无自主神经功能障碍的临床体征，但少数患者可能首发表现为尿失禁和大便失禁。我们对12例符合可能或确诊PSP临床标准的患者进行了肛门括约肌肌电图研究，其中2例有膀胱和肛门括约肌功能障碍的临床表现。研究结果与6例PD患者和6例MSA患者的结果进行了比较。12例PSP患者中有5例（41.6%）肛门括约肌检查异常。这些患者的异常运动单位与MSA患者中观察到的无法区分。MSA患者异常运动单位的比例最高，而PD患者最低。我们得出结论，一些PSP患者可能在肛门括约肌存在失神经支配的肌电图征象，仅通过此项检查无法将他们与MSA患者区分开来。
