肛门括约肌定量肌电图中神经病变的诊断标准

Criteria for neuropathic abnormality in quantitative anal sphincter e lectromyography

For the external anal sphincter muscle, both normative values and an optimal s et of motor unit potential (MUP) parameters have been defined. However, criteria for the diagnosis of neuropathic conditions have not yet been validated. Theref ore, in this study, sensitivity was examined in 86 patients with cauda equina le sions (227 muscles), and specificity in 77 controls (119 muscles), using multi MUP analysis. Six previously defined diagnostic criteria (mean values and outlie rs for MUP area, duration, and number of turns) were used. An increase in the nu mber of diagnostic criteria required for muscle abnormality (two and three inste ad of one), and the application of more stringent normative limits resulted in a progressive increase in specificity from 74%to 99%(controls), and a decrease in sensitivity from 70%to 21%(patients). The data suggest that no single cut off diagnostic criterion has both satisfactory sensitivity and specificity. Intr oduction of the diagnostic categories of “possible,”“probable,”and “definit e”neuropathic abnormalities into quantitative electromyographic analysis is pro posed.