Ghavanini M R, Ghavanini A A
Department of Physical Medicine and Rehabilitation, Shiraz University of Medical Sciences, Iran.
Electromyogr Clin Neurophysiol. 1998 Dec;38(8):455-8.
The diagnosis of post-polio syndrome depends not only on clinical signs, but on sophisticated laboratory tests such as histochemical muscle biopsy and immunohistochemical studies which are very expensive and not available in all laboratories. From eighty-eight previous poliomyelitis victims, muscles with grade 4 or lower strength were examined electromyographically for fibrillation potentials and positive sharp waves. There were no muscles with grade III or IV fibrillation potential and positive sharp waves, 8 with grade I (3.7%) and 7 with grade II (3.2%). Fibrillation potentials were more frequent in muscles with lower grade of strength. The minimum time interval between primary insult and the time of evaluation for patients who had sign of denervation was 36 months. This was 28 months for patients who had no sign of denervation. So we can conclude that denervation beyond this time in muscles with power greater than 3/5 is highly suggestive of a new process rather than primary insult in patients with new atrophy or fatigue.
小儿麻痹后遗症的诊断不仅取决于临床症状,还依赖于复杂的实验室检查,如组织化学肌肉活检和免疫组织化学研究,这些检查费用高昂,并非所有实验室都能进行。对88例既往小儿麻痹症患者中肌力为4级或更低的肌肉进行了肌电图检查,以检测纤颤电位和正锐波。没有Ⅲ级或Ⅳ级纤颤电位和正锐波的肌肉,8例有Ⅰ级(3.7%),7例有Ⅱ级(3.2%)。肌力较低的肌肉中纤颤电位更常见。对于有失神经征象的患者,初次损伤与评估时间之间的最短时间间隔为36个月。对于没有失神经征象的患者,这一间隔为28个月。因此我们可以得出结论,对于出现新的萎缩或疲劳的患者,在肌力大于3/5的肌肉中,超过这个时间的失神经高度提示存在新的病变过程而非初次损伤。