Palace J, Chandiramani V A, Fowler C J
Department of Uro-Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom.
Muscle Nerve. 1997 Nov;20(11):1396-403. doi: 10.1002/(sici)1097-4598(199711)20:11<1396::aid-mus7>3.0.co;2-5.
It is clinically important, to distinguish between idiopathic Parkinson's disease (IPD) and multiple system atrophy (MSA) not only because of the implications for prognosis but also because urinary incontinence is often an early troublesome feature of MSA and by making the correct neurological diagnosis inappropriate urological surgery may be avoided. Onuf's nucleus in the sacral cord is the location of the anterior horn cells innervating the sphincters, and it is among central nervous system sites affected by neuronal cell loss in MSA but not in IPD. A systematic analysis of motor units recorded from the sphincter looking for changes of chronic reinnervation has therefore been used to distinguish between these conditions. Sphincter electromyography (EMG) was carried out in 126 patients with suspected MSA with review of their case notes up to 2 years later. Of those in whom a diagnosis of MSA was made, 82% had had an abnormal sphincter EMG.
区分特发性帕金森病（IPD）和多系统萎缩（MSA）在临床上具有重要意义，这不仅是因为其对预后的影响，还因为尿失禁往往是MSA早期令人困扰的特征，通过做出正确的神经学诊断，可以避免不适当的泌尿外科手术。骶髓中的奥努夫核是支配括约肌的前角细胞所在位置，它是MSA中受神经元细胞丢失影响的中枢神经系统部位之一，而IPD中则不受影响。因此，对从括约肌记录的运动单位进行系统分析，寻找慢性再支配的变化，已被用于区分这些病症。对126例疑似MSA患者进行了括约肌肌电图（EMG）检查，并在2年后复查了他们的病历。在确诊为MSA的患者中，82%的患者括约肌EMG异常。
