11/28/2023 0 Comments Als emg findings![]() ![]() A ultrassonografia apresentou taxas de detecção superiores à eletroneuromiografia, independentemente do tempo de sua avaliação e dos músculos avaliados. Já na ultrassonografia de 30 s, a acurácia nos pacientes foi de 82%. A acurácia da ultrassonografia de 10 s nos músculos foi de 70%, enquanto nos pacientes foi de 85%. A avaliação da taxa de detecção por pacientes não apresentou diferença significativa entre a ultrassonografia de 10 s e 30 s. A ultrassonografia, tanto de 10 s quanto de 30 s, apresentou taxa de detecção superior à eletroneuromiografia em todos os músculos avaliados. As ferramentas Quality Assessment of Diagnostic Accuracy Studies, versão 2, e RTI item bank foram utilizadas para avaliação da qualidade do método. Foram realizadas buscas nas bases de dados eletrônicas Cochrane Library, MEDLINE, Embase e Lilacs, para estudos que avaliam a acurácia diagnóstica e as taxas de detecção da ultrassonografia e eletroneuromiografia. O objetivo deste estudo foi determinar a acurácia diagnóstica da ultrassonografia e da eletroneuromiografia para o diagnóstico da fasciculação e comparar suas taxas de detecção. ![]() Ultrasonography Electromyography Fasciculation Amyotrophic lateral sclerosis Ultrasound provided detection rates superior to those achieved with electromyography, independent of the examination time and muscles evaluated. The accuracy of ultrasound for 30 s was 82% in patients. The accuracy of ultrasound for 10 s was 70% in muscles and 85% in patients. The overall detection rate (in patients) did not differ significantly between ultrasound for 10 s and ultrasound for 30 s. Ultrasound, for 10 s or 30 s, had a higher detection rate than did electromyography in all muscles evaluated. The Quality Assessment of Diagnostic Accuracy Studies, version 2, and RTI item bank tools were used for the evaluation of methodological quality. ![]() By searching the Cochrane Library, MEDLINE, Excerpta Medica, and Latin-American and Caribbean Health Sciences Literature databases, we identified studies evaluating the diagnostic accuracy and fasciculation detection rates of ultrasound and electromyography. Peak ratio interference pattern analysis is largely not helpful in detecting this involvement.The objective of this study was to determine the diagnostic accuracy of ultrasound and electromyography for the detection of fasciculation in patients with amyotrophic lateral sclerosis and to compare detection rates between the two methods. Subclinical bulbar involvement could be detected by quantitative MUAP analysis in six ALS patients without clinical bulbar signs, and by peak ratio interference pattern analysis in two.Ĭonventional needle EMG of the fifth, seventh, and eleventh cranial nerve innervated muscles shows subclinical bulbar involvement quite frequently. If a result of either EMG technique was neuropathic in at least one of the three investigated muscles, bulbar involvement was assumed. Peak ratio interference pattern analysis was interpreted as neuropathic if the peak ratio, the number of small time intervals, or both were below the mean (-2 SD). Quantitative MUAP analysis was interpreted as neuropathic if MUAP duration, MUAP amplitude, or both exceeded the mean (+2 SD). The normal mean (2 SD) peak ratio of the frontalis was 2.3 (1.1) milliseconds masseter, 1.2 (0.4) milliseconds and sternocleidomastoideus, 1.5 (0.7) milliseconds. The normal mean (2 SD) MUAP duration of the frontalis muscle was 7.4 (2.2) milliseconds masseter muscle, 9.3 (3.1) milliseconds and sternocleidomastoideus muscle, 10.9 (4.1) milliseconds. With both electromyographic (EMG) techniques, electrical activity was recorded via needle electrodes from the right frontalis, masseter, and sternocleidomastoideus muscles of nine ALS patients without clinical bulbar signs (Frenchay score >85%) aged 40 to 87 years 21 healthy subjects aged 27 to 74 years and five ALS patients with clinical bulbar signs (Frenchay score <85%) aged 53 to 69 years. To determine if quantitative motor unit action potential (MUAP) analysis and peak ratio interference pattern analysis of the fifth, seventh, and eleventh cranial nerve innervated muscles are helpful in the assessment of subclinical bulbar involvement in ALS.
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