Objective To assess the significance of single fiber electromyography (SFEMG) in diagnosis of inflammatory myo-pathies and the correlation with other assistant examination findings. Methods SFEMG were recorded from th...Objective To assess the significance of single fiber electromyography (SFEMG) in diagnosis of inflammatory myo-pathies and the correlation with other assistant examination findings. Methods SFEMG were recorded from the extensor digitorum communis of 34 patients with polymyositis or dermato-myositis and compared with the findings of routine electromyography (EMG), serum creatine kinase (CK) determination, and muscle biopsy. Results SFEMG recordings in 34 patients were all abnormal. The prominent feature was markedly increased fiber density (FD) with normally or mildly increased jitter. FD ranged from 1.0 to 6.0 (2.34±0.43). Jitter ranged from 5 to 78 μs (41.6±10.3 μs). The potential pairs with jitter values greater than 55 μs ranged from 0% to 55% (7.7% ± 11.8%). Block was detected at one recording site in only one patient. Routine EMG demonstrated myogenic lesions in only 24 patients (70.6%). FD was a little higher in the normal-EMG subgroup or the neurogenic-EMG subgroup than myogenic-EMG subgroup but without statistical significance. Elevated CK levels were found in 75% patients (24/32). FD in the normal CK subgroup was significantly higher than that in the elevated CK subgroup (2.62±0.40 vs. 2.28±0.40, P < 0.05). Muscle pathologies were consistent with the diagnosis of myositis in 75% (15/20).Conclusion SFEMG is of great value in the diagnosis and disease process understanding of inflammatory myopathies for the clinically suspected patients with normal routine EMG, CK levels, and muscle biopsies.展开更多
Background Single fiber electromyography (SFEMG) is a sensitive technique for detecting abnormalities in neuromuscular transmission and is mainly used in the diagnosis of neuromuscular junction disorders, such as myas...Background Single fiber electromyography (SFEMG) is a sensitive technique for detecting abnormalities in neuromuscular transmission and is mainly used in the diagnosis of neuromuscular junction disorders, such as myasthenia gravis While the process of denervation reinnervation in amyotrophic lateral sclerosis (ALS) can also result in immature collateral nerve terminals and instability of neuromuscular transmission, the purpose of this study was to investigate the changes and clinical values of SFEMG in patients with ALS Methods Volitional SFEMG was performed on the extensor digitorum communis (EDC) of 78 patients with ALS (men 52, women 26) who had been previously diagnosed by history, clinical features, and neurophysiological studies The mean jitter, the percentage of jitter >55 μs, the impulse blocking percentage, and fiber density (FD) were determined These results were compared to normal controls In addition, the SFEMG indices were analyzed for correlations with the duration of ALS, the EDC strength score on the Medical Research Council (MRC) scale, and spontaneous activity detected by EMG studies Results SFEMG indices were abnormal in all patients with ALS Mean jitter ranged from 30 to 178 μs (mean 80 2 μs); the percentage of jitter >55 μs ranged from 5% to 100% (mean 60 5%) In addition, the impulse blocking percentage ranged from 0% to 90% (mean 28 1%) and FD ranged from 1 4 to 4 1 (mean 2 6) Mean jitter, the percentage of jitter >55 μs, and the blocking percentage in 57 patients with definite or probable ALS were significantly higher than in patients with possible or suspected ALS MRC scores of the EDC negatively correlated with mean jitter, the percentage of jitter >55 μs, blocking percentage, and FD Conclusions SFEMG is the most sensitive tool for diagnosing definite or probable ALS Increased jitter, blocking percentage, and FD can indicate the degree of immature collateral sprouts and motor end plates resulting from the progressive denervation and reinnervation associated with ALS, and may be helpful in evaluating prognosis展开更多
Background The aim of this study was to evaluate single fiber electromyography (SFEMG) in the diagnosis of ocular myasthenia gravis (OMG),compared with repetitive nerve stimulation (RNS) and blood concentration of ant...Background The aim of this study was to evaluate single fiber electromyography (SFEMG) in the diagnosis of ocular myasthenia gravis (OMG),compared with repetitive nerve stimulation (RNS) and blood concentration of antibody to acetylcholine receptor (AchRAb).Methods SFEMG,RNS and AchRAb titration were measured in 90 patients with OMG (44 men,46 women). Results Markedly increased jitter and ratio of block in the frontalis and the extensor digitorum communis (EDC) were observed (83.3% and 61.1%,respectively). The mean jitter was 43.6±14.5 μs,and the percentages of jitter>55 μs and blocking were 16.9%±19% and 3.5%±9.5% respectively in the EDC. The mean jitter was 64.3±25.6 μs,and the percentages of jitter >55 μs and blocking were 33.5%±27.6% and 29.3%±23.2% respectively in the frontalis. The percentage of abnormal RNS was 27.8% (25/90). There was an increased AchRAb titration in 29 (32.2%) of the 90 patients. Increased jitter,blocking was negatively correlated with maximum decrement to RNS ( P <0.01). 11.4% (4/35) of patients with abnormal RNS and 24.1% (7/29) patients with abnormal AchRAb were seen in the patients with normal SFEMG in the EDC. Conclusion SFEMG test showed the highest sensitivity in the diagnosis of OMG. To our knowledge, the three methods (SFEMG,RNS and AchRAb) are complementary in the diagnosis and differential diagnosis of OMG.展开更多
Intragastric botulismus toxin-A (BoNT-A) is one of the new approaches in the treatment of obesity. We aimed to contribute to the literature by presenting the clinical features, laboratory findings and treatment respon...Intragastric botulismus toxin-A (BoNT-A) is one of the new approaches in the treatment of obesity. We aimed to contribute to the literature by presenting the clinical features, laboratory findings and treatment responses of iatrogenic botulism cases due to intragastric BoNT-A administered in our clinic. All detailed medical information was obtained by accessing the medical records of the patients who were hospitalized and followed up and treated between September 2022 and December 2022, and the diagnosis of A.05.1 Botulism was entered according to ICD-10, and whose clinical findings were compatible with botulism disease and who underwent intragastric BoNT-A application beforehand. These records were obtained by examining this information. 10 patients who developed botulism after intragastric BoNT-A application between 01/09/2022 and 28/02/2023 were followed up in our clinic. All of the patients were women. The mean age was 35. The mean hospital stay was 9 days. Only 1 of our cases required intensive care. Good response to treatment was accepted as a complete or near-complete improvement in the clinical findings of the patients and all of them had a good response to treatment. Intragastric BoNT-A administration is a procedure that requires careful indication with a profit/loss calculation considering the potential side effects. In addition, attention should be paid to dilution rates and dose amounts.展开更多
文摘Objective To assess the significance of single fiber electromyography (SFEMG) in diagnosis of inflammatory myo-pathies and the correlation with other assistant examination findings. Methods SFEMG were recorded from the extensor digitorum communis of 34 patients with polymyositis or dermato-myositis and compared with the findings of routine electromyography (EMG), serum creatine kinase (CK) determination, and muscle biopsy. Results SFEMG recordings in 34 patients were all abnormal. The prominent feature was markedly increased fiber density (FD) with normally or mildly increased jitter. FD ranged from 1.0 to 6.0 (2.34±0.43). Jitter ranged from 5 to 78 μs (41.6±10.3 μs). The potential pairs with jitter values greater than 55 μs ranged from 0% to 55% (7.7% ± 11.8%). Block was detected at one recording site in only one patient. Routine EMG demonstrated myogenic lesions in only 24 patients (70.6%). FD was a little higher in the normal-EMG subgroup or the neurogenic-EMG subgroup than myogenic-EMG subgroup but without statistical significance. Elevated CK levels were found in 75% patients (24/32). FD in the normal CK subgroup was significantly higher than that in the elevated CK subgroup (2.62±0.40 vs. 2.28±0.40, P < 0.05). Muscle pathologies were consistent with the diagnosis of myositis in 75% (15/20).Conclusion SFEMG is of great value in the diagnosis and disease process understanding of inflammatory myopathies for the clinically suspected patients with normal routine EMG, CK levels, and muscle biopsies.
文摘Background Single fiber electromyography (SFEMG) is a sensitive technique for detecting abnormalities in neuromuscular transmission and is mainly used in the diagnosis of neuromuscular junction disorders, such as myasthenia gravis While the process of denervation reinnervation in amyotrophic lateral sclerosis (ALS) can also result in immature collateral nerve terminals and instability of neuromuscular transmission, the purpose of this study was to investigate the changes and clinical values of SFEMG in patients with ALS Methods Volitional SFEMG was performed on the extensor digitorum communis (EDC) of 78 patients with ALS (men 52, women 26) who had been previously diagnosed by history, clinical features, and neurophysiological studies The mean jitter, the percentage of jitter >55 μs, the impulse blocking percentage, and fiber density (FD) were determined These results were compared to normal controls In addition, the SFEMG indices were analyzed for correlations with the duration of ALS, the EDC strength score on the Medical Research Council (MRC) scale, and spontaneous activity detected by EMG studies Results SFEMG indices were abnormal in all patients with ALS Mean jitter ranged from 30 to 178 μs (mean 80 2 μs); the percentage of jitter >55 μs ranged from 5% to 100% (mean 60 5%) In addition, the impulse blocking percentage ranged from 0% to 90% (mean 28 1%) and FD ranged from 1 4 to 4 1 (mean 2 6) Mean jitter, the percentage of jitter >55 μs, and the blocking percentage in 57 patients with definite or probable ALS were significantly higher than in patients with possible or suspected ALS MRC scores of the EDC negatively correlated with mean jitter, the percentage of jitter >55 μs, blocking percentage, and FD Conclusions SFEMG is the most sensitive tool for diagnosing definite or probable ALS Increased jitter, blocking percentage, and FD can indicate the degree of immature collateral sprouts and motor end plates resulting from the progressive denervation and reinnervation associated with ALS, and may be helpful in evaluating prognosis
文摘Background The aim of this study was to evaluate single fiber electromyography (SFEMG) in the diagnosis of ocular myasthenia gravis (OMG),compared with repetitive nerve stimulation (RNS) and blood concentration of antibody to acetylcholine receptor (AchRAb).Methods SFEMG,RNS and AchRAb titration were measured in 90 patients with OMG (44 men,46 women). Results Markedly increased jitter and ratio of block in the frontalis and the extensor digitorum communis (EDC) were observed (83.3% and 61.1%,respectively). The mean jitter was 43.6±14.5 μs,and the percentages of jitter>55 μs and blocking were 16.9%±19% and 3.5%±9.5% respectively in the EDC. The mean jitter was 64.3±25.6 μs,and the percentages of jitter >55 μs and blocking were 33.5%±27.6% and 29.3%±23.2% respectively in the frontalis. The percentage of abnormal RNS was 27.8% (25/90). There was an increased AchRAb titration in 29 (32.2%) of the 90 patients. Increased jitter,blocking was negatively correlated with maximum decrement to RNS ( P <0.01). 11.4% (4/35) of patients with abnormal RNS and 24.1% (7/29) patients with abnormal AchRAb were seen in the patients with normal SFEMG in the EDC. Conclusion SFEMG test showed the highest sensitivity in the diagnosis of OMG. To our knowledge, the three methods (SFEMG,RNS and AchRAb) are complementary in the diagnosis and differential diagnosis of OMG.
文摘Intragastric botulismus toxin-A (BoNT-A) is one of the new approaches in the treatment of obesity. We aimed to contribute to the literature by presenting the clinical features, laboratory findings and treatment responses of iatrogenic botulism cases due to intragastric BoNT-A administered in our clinic. All detailed medical information was obtained by accessing the medical records of the patients who were hospitalized and followed up and treated between September 2022 and December 2022, and the diagnosis of A.05.1 Botulism was entered according to ICD-10, and whose clinical findings were compatible with botulism disease and who underwent intragastric BoNT-A application beforehand. These records were obtained by examining this information. 10 patients who developed botulism after intragastric BoNT-A application between 01/09/2022 and 28/02/2023 were followed up in our clinic. All of the patients were women. The mean age was 35. The mean hospital stay was 9 days. Only 1 of our cases required intensive care. Good response to treatment was accepted as a complete or near-complete improvement in the clinical findings of the patients and all of them had a good response to treatment. Intragastric BoNT-A administration is a procedure that requires careful indication with a profit/loss calculation considering the potential side effects. In addition, attention should be paid to dilution rates and dose amounts.
