Another Perspective on Fasciculations: When is it not Caused by the Classic form of Amyotrophic Lateral Sclerosis or Progressive Spinal Atrophy?
Another Perspective on Fasciculations: When is it not Caused by the Classic form of Amyotrophic Lateral Sclerosis or Progressive Spinal Atrophy?
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DOI：
10.4081/ni.2014.5208
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发表时间：
2014-08-05
影响因子：
3
通讯作者：
Oliveira AB
中科院分区：
文献类型：
--
作者：
Leite MA;Orsini M;de Freitas MR;Pereira JS;Gobbi FH;Bastos VH;de Castro Machado D;Machado S;Arrias-Carrion O;de Souza JA;Oliveira AB
肌束是可见的，精细和快速的，有时是自发和间歇发生的细肌纤维的蠕虫状收缩。本文的目的是讨论肌束震颤的主要原因及其在中枢/外周损伤的不同部位的病理生理学，特别是反驳神经系统检查中存在这种发现是肌萎缩侧索硬化症的指示。毫无疑问，在正常人和运动神经元疾病患者中，大多数肌束震颤都起源于运动神经的远端。它们中的大多数扩散到其他树突棘，通常在主要轴突中产生逆向冲动。临床和神经生理学诊断必须彻底。用神经肌电图记录肌束震颤通常需要很长时间。在其他情况下，在诊断之前需要进行时间监测。这种治疗在某些情况下可能是适当的，但并不总是必要的。
Fasciculations are visible, fine and fast, sometimes vermicular contractions of fine muscle fibers that occur spontaneously and intermittently. The aim of this article is to discuss the main causes for fasciculations and their pathophysiology in different sites of the central/peripheral injury and in particular to disprove that the presence of this finding in the neurological examination is indicative of amyotrophic lateral sclerosis. Undoubtedly, most fasciculations have a distal origin in the motor nerve both in normal subjects and in patients with motor neuron disease. Most of them spread to other dendritic spines often producing an antidromic impulse in the main axon. The clinical and neurophysiological diagnosis must be thorough. It may often take long to record fasciculations with electroneuromyography. In other cases, temporal monitoring is necessary before the diagnosis. The treatment, which may be adequate in some cases, is not always necessary.