不同起病部位的ALS病人异常肌电区域分布研究

目的 :探讨不同起病部位的ALS病人在 4个下运动神经元支配区域异常肌电的分布情况。方法 :对 10 2例临床诊断为ALS的病人分别行 4组下运动神经元区域 (脑干 ,颈 ,胸 ,腰骶髓 )的针极肌电图检查。对 87例同时进行了胸锁乳突肌的检查。结果 :4组肌电检查区域的结果示 :颈段与胸段异常率在各起病组中最高 ,脑干及腰骶段在各组中异常率不同 (差异有显著意义 ,P <0 0 5 ) ;胸锁乳突肌上、下肢起病组的异常率均高于同组的脑干支配肌。结论 :在ALS病人中 ,异常肌电的分布与起病部位有关。不论哪一部位起病 ,4个区域均可受累 ,因此必须全都检查。胸锁乳突肌具有特殊的诊断及鉴别诊断价值

Electromyographic Regional Differences in ALS Patients with Different Initiative Symptom of Onset

Aim:To determine electromyographic involvement and differences in four groups of lower motor neurons in amyotrophic lateral sclerosis (ALS) patients with different initiative symptoms of onset. Methods:Electrical activity was recorded via needle electrodes from muscles innervated by brainstem, cervical thoracic and lumbosacral motor neuron regions in 102 patients clinically diagnosed as ALS. Among them,87 cases received sternocleidomastoid (SCM) muscle examination. Results:Differences of regional vulnerability were found in patients with different initiative symptom of onset, neurogenic activities were more frequent in cervical and thoracic muscles in all patients ( P >0 05), brainstem and lumbosacral muscles were involved differently with different onset ( P <0 05); in limb-onset patients, involvement of SCM is higher than that of brainstem muscles. Conclusion:In ALS patients, different initiative symptom of onset causes different distribution of electromyographic findings; all four regions respectively would be involved and should be examined whatever the initiative symptom; SCM has special significance in diagnosis and differential diagnosis.