Dislocation and disappearance of muscle motor points in needle electromyography

Мұқаба

Дәйексөз келтіру

Толық мәтін

Ашық рұқсат Ашық рұқсат
Рұқсат жабық Рұқсат берілді
Рұқсат жабық Рұқсат ақылы немесе тек жазылушылар үшін

Аннотация

Background: Dislocation or disappearance of a motor point (MP) is the detection of MP in a location different from that indicated in the anatomical atlas or the inability to detect it with the maximum possible muscle tension.

Objective: Assessment of the prevalence and specificity of the phenomenon of MP dislocation/disappearance.

Materials and methods: Needle electromyography was performed on 120 muscles in patients with peripheral nervous system diseases with neurogenic denervation and with anxiety disorders without neurological symptoms. The depth of muscle paresis, spontaneous activity, parameters of motor unit potentials, and the nature of MP dislocation when detected were assessed. Magnetic resonance imaging (MRI) of the muscles was performed in 2 patients with MP dislocations. Additionally, 10 neurophysiologists were interviewed regarding the frequency of detection of the phenomenon.

Results: The phenomena of MP dislocation and disappearance were detected in 4.2% of the examined muscles; in 2 patients – with amyotrophic lateral sclerosis in the lateral gastrocnemius muscles, in 2 – with adult spinal muscular atrophy (SMA) in the common extensor of the fingers and the medial gastrocnemius muscle, respectively, in 1 – with anxiety disorder. MRI of the muscles in the patient with SMA showed a more pronounced signal change in the muscle with dislocation, in the patient with anxiety disorder – a normal MR signal in the affected muscle. Dislocated points in all cases were located proximally and lateral to the place of their «atlas» location. In sensorimotor axonal polyneuropathy and Parsonage-Turner syndrome, dislocation and disappearance of MP were not detected. Of the 10 surveyed neurophysiologists, 2 encountered the phenomenon of dislocation in the gastrocnemius muscles.

Conclusion: The phenomenon of MP dislocation/disappearance is rare in electromyographic practice. The phenomenon in neurological diseases is probably based on a change in the anatomical relationships of denervated muscles. Also, the disappearance of MP can be detected in patients with mental disorders when they interfere with the methodically correct conduct of the study.

Толық мәтін

Рұқсат жабық

Авторлар туралы

Elena Kovrazhkina

Federal Center for Brain and Neurotechnology FMBA of Russia

Email: alsrus@gmail.com

Cand. Sci. (Med.), Neurologist, Functional Diagnostics Specialist, doctor at the Functional Diagnostics Department

Ресей, Moscow

Gleb Levitsky

“Gleb Levitsky Clinic” with a Private Center for Amyotrophic Lateral Sclerosis

Хат алмасуға жауапты Автор.
Email: alsrus@gmail.com

Cand. Sci. (Med.), Neurologist, Functional Diagnostics Specialist, General Director, International Emissary for ALS Patients’ Rights

Ресей, Moscow

Dmitry Kazakov

Veltischev Research Clinical Institute of Pediatrics; Pirogov Russian National Research Medical University

Email: alsrus@gmail.com

Radiologist

Ресей, Moscow; Moscow

Maksim Gaidash

Central Clinical Hospital with a Polyclinic of the Presidential Administration of the Russian Federation

Email: alsrus@gmail.com

Neurologist

Ресей, Moscow

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2. Figure. MRI of the calf muscles, T1 Wl (left) and T2 Dixon water (right) of a patient with adult spinal muscular atrophy

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