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Motor neuron disease (Motor neuron disease, MND) is a progressive neurological degenerative diseases, mainly involving the upper and lower motor neurons. Lesions involving the location and course of the disease can be divided into many types, the most important of amyotrophic lateral sclerosis (Amyotrophic lateralsclerosis, ALS) and spinal muscular atrophy (Progressive muscular atrophy, PMA). MND diagnosis relies on clinical manifestations, conventional electromyography (EMG) examination have a very important value, but the positive rate and have certain limitations of the early MND diagnosis. The early 1960s, the Swedish scholar Stalberg and Ekstedt first carried out the new single fiber electromyography (SFEMG) electrophysiological testing technology for the identification and recording from a single muscle fiber action potential (AP), helps us understand the muscle physiology and pathophysiology. The SFEMG main Determination of the content: (1) EMG shaking (jitter); (2) muscle fiber density (FD). In patients with ALS and PMA constantly lower motor nerve yuan degeneration, death, residual muscle fibers will be by the adjacent sports nerve collateral buds born again dominate, change caused FD increase muscle fiber group of type; formation of collateral sprouting final movement board immature, the safety factor is decreased, resulting in Jitter broadening. So we will see increased jitter Zhejiang University School of Medicine postgraduate thesis widened and FD value in patients with ALS and PMA. In this study, by SFEMG in patients with MND Jitter values ??and FD value determination, combined with conventional EMG, to explore the significance of SFEMG diagnosis of MND. First, research and pocket the object l, MND group: 38 cases, based on history, clinical signs diagnosed with ALS or PMA. The diagnostic criterion-referenced the 1994 World Federation of Neurology developed the EI EScortal diagnostic criteria and the revised standard. By conventional EMG, nerve conduction velocity, biochemical tests and imaging studies to exclude other nerve and muscle diseases easily confused with ALS or PMA. Which the ALS27 cases PMALL cases. The group conventional EMG, and SFEMG checks which conventional EMG three limb muscles and sternocleidomastoid, SFEMG subjects the muscles extensor digitorum. 2, the normal control group: 30 cases were system other healthy volunteers, nervous system disease patients o migraine, neurosis, epilepsy carbuncle L normal control group, sex, age constitute than no significant difference with the MND group (P> 0 knife 5 ). The group SFEMG examination. Second, of persimmon touch Parties, the resolution the EM G inspection equipment for Denmark Dundee keypoint2000 type EMG instrument. The recording electrodes for the special single fiber needle electrode. Determination of the total extensor Jha and FD values. The results of the diagnostic criterion-referenced Stalbeffi, AAEM and domestic Cui recommended to determine positive standard. 2, the conventional EMG examination equipment with SFEMG. The recording electrode concentric needle electromyography. Muscle EMG measurements, we divided into four steps: I) insertion potential (2) resting: To observe whether spontaneous potential appears, spontaneous potential positive sharp waves, II l Master of Zhejiang University School of Graduate paper T-mortar) light contraction: the determination of MUP. Get 10 to 20 the different waveforms MU P, ??calculate the average time limit average volatility, and polyphasic percentage. I results to determine the criterion-referenced standard of the Beijing Union Medical College Hospital EMG room: the average duration of more than 20% I The normal muscle, the average volatility of more than 70% of the normal ruled neurogenic damage. N) strong contraction; leads to raise potentiometer. Raising potential types of interference phase, mixed phase 1 and phase alone. 7 according to Kang Dexuan, Tang Xiao-fu recommended subjects muscles, including three-limb muscle + muscle, a three-limb muscles: upper thenar, lower extremity embryonic muscle. Three limb muscles and sternocleidomastoid neurogenic damage was extensive neuronal damage, to determine positive, suggesting that motor neuron disease 7. D 3, nerve conduction velocity each MND patients the median nerve, ulnar nerve cavity nerves and nerve conduction velocity was measured with S enteric nervous 7I, including MCV and SCV. ] (D) statistical processing lthe data using a knife SPSS10 package analysis and processing. I use two sets of measurement data homogeneity of variance t test for unequal variances t 'test, count data using the X' test. 11 MND group and normal control group average MCD and FD values ??MND group The average dish D is 88.42130.4 ... S, normal control group the average MCD 30.401 ± 5.06ps results suggest MN'D group than normal. Jitter value of the control group was significantly widened, I significant difference (P <0 Knife 01), wide test. The average IMND group FD value 2.84f0.69 of the normal control group, the average FD value l. 33 0.11 l results?
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