不同起病部位肌萎缩侧索硬化患者的肌电图研究

Study of EMG in ALS patients with initiative symptoms in different site

目的:观察不同起病部位的肌萎缩侧索硬化(ALS)患者下运动神经元支配区域异常肌 电图(EMG)的分布情况,评价其EMG检测在早期诊断中的意义。方法:对60例诊断为ALS的病例进 行脑干、脊髓颈段、胸段、腰骶段四个下运动神经元区域的肌电图检查,分析临床表现和EMG检查结 果。结果:延髓起病组腰骶段异常率最低,下肢起病组延髓节段异常率最低;颈段和腰骶段中肢体远端 肌肉异常率明显高于肢体近端肌肉。结论:ALS起病部位不同,下运动神经元区域肌电图异常分布情况 也不同。检查颈段和腰骶段时首选肢体远端肌肉,延髓节段首选胸锁乳突肌。

Objective: To observe the abnormal EMG distribution in regions in nervated by lower motor neurons of amyotrophic lateral sclerosis(ALS) patients with initiative symptoms in different site and to evaluate the significance of EMG in regions innervated by different lower motor neurons in the early diagnosis of ALS. Methods: The lower motor neurons(of brainstem, cervical spinal cord, thoracic and lumbosacral spinal cord)in nervated regions EMG were determined in 60 patients diagnosed as ALS. The clinical features and the EMG results were analyzed. Results:The abnormality rate of EMG in lumbosacral group was the lowest in patients with bulbar onset. and the abnormality rate of EMG in bulbar group was the lowest in patients with lower limb onset. The abnormality rate of EMG of distal hmbmuscles in cervical and lumbosacral groups were much higher than those of the proximal limb muscles in the same groups. Conclusions:In ALS patients,different site of onset symptoms determine different distribution of abnormal EMG. When examining the cervical and lumbosacral group the distal muscles of limbs should be s elected first,while in the brainstem group muscles,sternocleidomastoid should be the first.