运动神经元病患者胸锁乳突肌肌电图的特征

目的探讨运动神经元病(MND)患者胸锁乳突肌(SCM)肌电图的特征。方法回顾性分析461例MND患者及349例非MND患者的临床和肌电图资料。结果MND组SCM肌电图异常率(60.3%)显著高于非MND组(4.6%)(P<0.01);确诊级MND患者SCM肌电图的异常率(77.4%)明显高于其他诊断级(均P<0.01);MND组中,SCM肌电图的异常率(60.3%)低于上、下肢体肌肉的肌电图(93.2%、84.4%)(均P<0.001);MND患者SCM肌电图异常以自发电位(42.5%)和轻收缩时运动单位电位时限增宽(43.2%)最为常见;MND组有延髓症状者SCM肌电图的异常率(71.7%)明显高于无延髓症状者(54.3%)(P<0.05)。结论MND患者SCM肌电图异常率及其特异性高,为延髓肌受累的指征,有助于MND的诊断与鉴别诊断。

Electromyographic characteristics of sternocleidomastoid muscle in patients with motor neuron disease

Objective To investigate the electromyographic(EMG)characteristics of sternocleidomastoid muscle in patients with motor neuron disease.Methods The clinical and EMG data of 461 patients of MND group and 349 of non-MND group were analyzed retrospectively.Results The abnormality rate of sternocleidomastoid EMG in MND group was 60.3%,much higher than that in non-MND group(4.6%)(P<0.01).The abnormality rate of sternocleidomastoid EMG in confirmed MND subgroup was 77.4%,much higher than other subgroups in MND group(all P<0.01).In MND group,the abnormality rate of sternocleidomastoid EMG was 60.3%,lower than that in upper and lower limb muscles EMG(93.2%,84.4%)(all P<0.01).Among EMG neuropathic changes of sternocleidomastoid muscles,spontaneous activity and increased duration of motor unit action potentials were most common,the incidence were 42.5% and 43.2% respectively.In MND group,the abnormality rate of sternocleidomastoid EMG was higher in MND patients(71.7%)with bulbar signs than that without bulbar signs(54.3%)(P<0.05).Conclusions MND has higher abnormality rate of sternocleidomastoid EMG indicates more specificity and is relevant to bulbar signs,which will be helpful in the diagnosis and differentiating of MND.