Document Detail


Study of central and peripheral conductions to the diaphragm in 22 patients with definite multiple sclerosis.
MedLine Citation:
PMID:  9783118     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Involvement of the diaphragm was evaluated electrophysiologically in 22 patients with definite multiple sclerosis. Magnetic transcranial stimulation (MTS), magnetic cervical stimulation at C4 level (MCS) and electric stimulation of the phrenic nerve at the neck (EPS) were performed for measuring latencies, motor conduction times and amplitudes of the responses recorded with a pair of surface or subcutaneous electrodes located at the xiphoid and the 8th costal interspace on the anterior axillary line. Latency of the motor evoked potentials (MEPs) was abnormal: in 9 patients following MTS, in 6 following MCS, in 2 following EPS. The motor conduction time between the cortex and the cervical spine, we called CMCT1, was abnormal in 11 patients and the motor conduction time between the cortex and the neck, we called CMCT2, was abnormal in 8 patients. However CMCT1 was more often unmeasurable than CMCT2 because the MEPs following MCS were unreliable in 4 patients. The conduction time between the cervical spine and the neck was abnormally long in 2 patients but it was paradoxically abnormally short in 3, probably because of the difficulties in locating exactly the place of the stimulation at the cervical C4 level. The MEP amplitude was not considered a reliable parameter because of the large range of the values in our controls, although the mean amplitude was significantly lower in the patients than in the controls. The amplitude of the compound muscle action potential (CMAP) following EPS was below the lower limit of the normal in 9 patients. The percentage of abnormal MEP latencies and CMCTs when both sides were combined was higher for the hemidiaphragms than for the upper limbs and was roughly the same for the hemidiaphragms and the lower limbs. Moreover electrophysiological study of the diaphragm was abnormal in 5 patients without pulmonary symptoms and with normal pulmonary function tests, demonstrating that this study is useful for revealing infraclinical demyelinating lesions on the central motor pathways down to diaphragm. In addition, alterations of the CMAPs in some patients suggest a possible extension of the lesions towards the anterior horns and anterior roots.
Authors:
A Lagueny; A Arnaud; G Le Masson; P Burbaud; P Deliac; R Marthan
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Electromyography and clinical neurophysiology     Volume:  38     ISSN:  0301-150X     ISO Abbreviation:  Electromyogr Clin Neurophysiol     Publication Date:  1998 Sep 
Date Detail:
Created Date:  1998-12-23     Completed Date:  1998-12-23     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0327533     Medline TA:  Electromyogr Clin Neurophysiol     Country:  BELGIUM    
Other Details:
Languages:  eng     Pagination:  333-42     Citation Subset:  IM    
Affiliation:
Department of Neurology, Hopital du Haut leveque, Pessac.
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MeSH Terms
Descriptor/Qualifier:
Adult
Diaphragm / innervation*,  physiopathology
Electromyography
Female
Humans
Male
Middle Aged
Multiple Sclerosis / physiopathology*
Nerve Fibers / physiology*
Neural Conduction / physiology*
Respiratory Function Tests

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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