Anal sphincter EMG in the diagnosis of parkinsonian syndromes
Anal sphincter EMG in the diagnosis of parkinsonian syndromes
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DOI：
10.1111/j.1600-0404.2009.01169.x
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发表时间：
2010-03-01
影响因子：
3.5
通讯作者：
Werdelin, L.
中科院分区：
文献类型：
--
作者：
Winge, K.;Jennum, P.;Werdelin, L.
背景--从肛门外括约肌(EAS)记录的肌电(EMG)在诊断非典型帕金森综合征中的作用仍是一个持续争论的问题。大多数关于这个问题的研究都是回溯性的。方法：对6例帕金森病(IPD)、14例多系统萎缩(MSA)和8例进行性核上性麻痹(PSP)患者进行了EAS肌电、EAS运动诱发电位(MEP)、腓肠肌EMG运动诱发电位(MEP)和腓肠神经神经传导速度检测。患者随访2年，以确保正确的诊断。结果：MSA和PSP患者EAS记录的运动单位电位(MUPs)的平均持续时间明显长于PD患者的MUP(P<；0.005)。没有运动神经元弥漫性丢失或周围神经病变的迹象。MEP在MSA患者中显示出核上损害的征象，而在PSP患者中，其机制是Onuf核运动神经元的局灶性丢失。结论：EAS的肌电异常强烈提示非典型帕金森病，MSA和PSP患者的病理生理学可能不同。
Background - The role of electromyography (EMG) recorded from the external anal sphincter (EAS) in the diagnosis of atypical parkinsonian syndromes is a matter for continuous debate. Most studies addressing this issue are retrospective. Methods - In this study, we prospectively investigated six patients with Parkinson's Disease (IPD), 14 patients with multiple system atrophy (MSA) and eight with progressive supranuclear palsy (PSP) using EMG of the EAS, motor-evoked potential (MEP) to the EAS and EMG of m. gastrocnemius and nerve conduction velocity measured at the sural nerve. Patients were followed up for 2 years to secure correct diagnosis. Results - The mean duration of motor unit potentials (MUPs) recorded from the EAS was significantly longer in patients with MSA and PSP compared with MUPs recorded from patients with PD (P < 0.005 for both). There were no signs of diffuse loss of motor neurons or peripheral neuropathy. MEP revealed signs of supranuclear affection in patients with MSA, whereas in patients with PSP the mechanism is a focal loss of motor neurons in Onuf's nucleus. Conclusions - Abnormal EMG of the EAS is strongly suggestive of atypical parkinsonism and the pathophysiology may be different in patients with MSA and PSP.