Document Detail

Role of electromyography in amyotrophic lateral sclerosis.
MedLine Citation:
PMID:  1766455     Owner:  NLM     Status:  MEDLINE    
We reviewed the role of electrodiagnostic testing in amyotrophic lateral sclerosis (ALS) in a large ALS clinic. Over 31 months, 133 patients with a clinical diagnosis of ALS were tested. In most, nerve conduction studies were normal, and needle electrode examination showed active denervation in the upper and lower limbs or the limbs and bulbar muscles (Lambert's criteria). However, 50 of 133 patients did not fulfill Lambert's criteria at presentation because of abnormal nerve conduction studies (11 patients), abnormal F-wave latencies (6 patients), or insufficiently distributed fibrillation potentials (40 patients). This study reveals that a large proportion of patients with a clinical diagnosis of ALS fail to have classical findings on initial electrodiagnostic studies, and reveals several caveats of electrodiagnostic testing in these patients: (1) Conduction studies may be unreliable in motor nerves with markedly low compound muscle action potential (CMAP) amplitudes. (2) Sensory nerve action potential (SNAP) amplitudes may be abnormal in a small percentage of otherwise typical ALS patients. However, better controls for elderly subjects are needed. (3) Needle electrode examination may not show widespread active denervation early in the disease. (4) Some patients may have a mild polyneuropathy. (5) The classic diagnostic criteria may need to be modified to allow earlier acceptance of many ALS patients into therapeutic trials.
M Behnia; J J Kelly
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Muscle & nerve     Volume:  14     ISSN:  0148-639X     ISO Abbreviation:  Muscle Nerve     Publication Date:  1991 Dec 
Date Detail:
Created Date:  1992-02-20     Completed Date:  1992-02-20     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803146     Medline TA:  Muscle Nerve     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1236-41     Citation Subset:  IM    
Neuromuscular Unit, Tufts Medical School, Boston, Massachusetts.
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MeSH Terms
Action Potentials / physiology
Amyotrophic Lateral Sclerosis / diagnosis*
Middle Aged
Motor Neurons / physiology
Muscles / innervation
Neural Conduction / physiology
Neurons, Afferent / physiology

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