Scheel A K, Toepfer M, Kunkel M, Finkenstaedt M, Reimers C D
Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany.
J Neuroimaging. 1997 Jan;7(1):23-7. doi: 10.1111/jon19977123.
In previous studies, ultrasonography was a very sensitive method in detecting fasciculations. The present study was intended to examine the prevalence of ultrasonographically visible fasciculations in patients with neuromuscular diseases affecting the lower extremities. Ultrasonography of 9 muscles (rectus femoris, vastus lateralis, vastus intermedius, vastus medialis, sartorius, semitendinosus, tibialis anterior, gastrocnemius, and soleus muscles) was performed bilaterally in 70 adult healthy subjects and 172 patients with various neuromuscular diseases. Fasciculations were detected in 109 (63%) of 172 patients. The median value of affected muscles was 10 (range 1-18). Patients with spinal muscular atrophy (37/38, p < 0.001), hereditary motor and sensory neuropathy (24/25, p < 0.001), and lumbosacral radiculopathy with motor deficits (24/29, p < 0.001) exhibited fasciculations more frequently than did healthy volunteers. Radiculopathy with sensory deficits, lesions of either plexus or peripheral nerves, compartment syndrome, and myopathy were not associated with a significantly enhanced prevalence of fasciculations in the patient group compared to the control group. In summary, fasciculations are a frequent ultrasonographic sign in neuromuscular diseases. They are almost regularly found in patients with spinal muscular atrophy and those with hereditary motor and sensory neuropathy. Thus, the absence of fasciculations in ultrasonographic assessment should give cause for reconsidering these diagnoses.
在以往的研究中，超声检查是检测肌束震颤的一种非常敏感的方法。本研究旨在检查超声可见的肌束震颤在影响下肢的神经肌肉疾病患者中的患病率。对70名成年健康受试者和172名患有各种神经肌肉疾病的患者双侧进行了9块肌肉（股直肌、股外侧肌、股中间肌、股内侧肌、缝匠肌、半腱肌、胫前肌、腓肠肌和比目鱼肌）的超声检查。172名患者中有109名（63%）检测到肌束震颤。受影响肌肉的中位数为10块（范围为1 - 18块）。脊髓性肌萎缩患者（37/38，p < 0.001）、遗传性运动和感觉神经病患者（24/25，p < 0.001）以及伴有运动功能缺损的腰骶神经根病患者（24/29，p < 0.001）比健康志愿者更频繁地出现肌束震颤。与对照组相比，感觉功能缺损的神经根病、神经丛或周围神经病变、骨筋膜室综合征和肌病患者组中肌束震颤的患病率没有显著增加。总之，肌束震颤是神经肌肉疾病中常见的超声征象。它们几乎经常出现在脊髓性肌萎缩患者和遗传性运动和感觉神经病患者中。因此，超声评估中未发现肌束震颤应促使重新考虑这些诊断。
