Alt Motor Nöron Tutulumu Olan Motor Nöron Hastalarında Genioglossus Kası Konsantrik İğne Tek Lif EMG Değerlendirmesi
Özet
Motor neuron diseases (MND) that cause progressive disability and death in time, while are diagnosed basicly by demonstrating the clinical or electrophysiological lower and/or upper motor neuron involvement in least two of cranio bulbar, cervical, thoracal and lumbar regions, not easy to distinguish from non degenerative diseases that have similar clinical and electrophysiological features like cervical spondilosis, motor neuropathy. Therefore, genioglossus muscle is used for diagnosis that is the most often involved in MND and for differential diagnosis the most important cranial innervated muscle. However there is evaluation problems in the routine resting needle EMG because of not relaxation and synchronous activities of the muscle with respiration. Current state is an advantage for single fiber EMG that is a quantitative technic. In this thesis study, we aimed to investigate the utility of concentric needle single fiber EMG of genioglossus muscle in the motor neuron diseases with lower motor neuron involvement which previously not examined. 21 patients who consecutively admit to Hacettepe University Department of Neurology EMG Laboratory with MND with lower motor neuron involvement that confirm by clinical and/or electrophysiological features and 22 control cases in whom MND is excluded with clinical and electrophysiological features enrolled to this study. The routine protocol of motor-sensory nerve conduction, F latance and cervical, thoracic and lumbosacral innervated at least two muscle and genioglossus muscle needle EMG and disposable concentric needle single fiber EMG were evaluated. The outlier and MCD values are obtained from control group?s single fibre EMG datas. On the routine EMG studies we determined denervation at 4 patients although 17 patients(%81) had at least 3 potantial pairs of abnormal outlier MCD value and the study accepted abnormal. This findings show that concentric needle single fibre EMG of genioglossus study is a useful technic for diagnosis and differential diagnosis of MND with determination of denervation-reinnervation process which had technical difficulties to denote with routine needle EMG.
