舌肌肌电图对运动神经元病诊断价值探讨

Electromyographic studies of tongue and sternocleidomastoid muscle in patients with motor neuron disease

目的:探讨舌肌肌电图(EMG)对运动神经元病(MND)的诊断价值。方法:对22例 MND患者[其中肌萎缩侧索硬化(ALS)13例,脊肌萎缩症(SMA)9例]进行常规EMG及胸锁乳突肌和舌肌EMG检查,并比较其结果。结果:MND患者EMG舌肌纤颤电位阳性率为59％,而临床表现舌肌纤颤仅32％,EMG敏感性高于临床表现,但经统计学分析差异不明显。ALS与SMA两组常规EMG 比较无明显差异。ALS组舌肌EMG纤颤电位62％(8／13例),胸锁乳突肌纤颤电位39％(5／13例),两者比较差异无统计学意义,但SMA组舌肌纤颤电位阳性率为56％(5／9),胸锁乳突肌EMG无纤颤电位,两者比较差异有统计学意义(P<0.05)。结论:舌肌EMG可作为诊断运动神经元病重要的辅助手段,其诊断价值高于胸锁乳突肌EMG,尤其对SMA病例,与胸锁乳突肌EMG相结合则诊断价值更大。

Objective：To investigate the electromyographic role of tongue and sternocleidomastoid muscles in diagnosis of motor neuron disease（MND）. Methods： EMGs of tongue and sternocleidomastoid muscles were examined in 22 patients with MND, including 13 cases of amyotrophic lateral sclerosis （ALS）and 9 cases of musculoraehidian atrophy（MRA）. Result： The incidence of tongue myokymic discharges（59%） is higher than clinical myokymia（32%） in MND. But there is no difference between them （P〉0.05）. Standard EMG shows no difference between ALS and MRA groups. Fibrillation potentials of tongue is 62 %（8/13）,and that of sternoeleidomastoid muscles is 39 %（5/13） in ALS, but there was no statistical significance between them; In MRA group, the difference between tongue（56%,5/9） and ster nocleidomastoid（0/9） was significant（P〈0.05）/Conclusions：The EMG examination of tongue can play an important role in the diagnosis of MND,and the Role of fibrillation potentials in tongue muscle is better than in sternocleidomastoid,especially in MRA. It is of great value on electromyogram of tongue eonbined with that of sternocleidomastoid muscles.