Résumé
Fasciculations and cramps originate in the motor unit, a functional unit that includes the lower motor neuron and their innervated muscle fibres. Both are common complaints in outpatient practice. These symptoms can be secondary to neurological or medical pathology, presenting a broad differential diagnosis and a complex approach. Recent neurophysiological studies have increased the knowledge of their origin mainly in amyotrophic lateral sclerosis. The symptomatic management of fasciculations and cramps depends on their etiology and includes pharmacological and non-pharmacological treatments. This article aims to present an updated review of the most relevant aspects of physiopathology, clinical approach, and differential diagnosis of both phenomena.
Sujets)
Humains , Fasciculation/diagnostic , Fasciculation/étiologie , Fasciculation/thérapie , Sclérose latérale amyotrophique/complications , Sclérose latérale amyotrophique/diagnostic , Sclérose latérale amyotrophique/thérapie , Électromyographie/effets indésirables , Motoneurones/physiologie , Crampe musculaire/diagnostic , Crampe musculaire/étiologie , Crampe musculaire/thérapieRésumé
EMG needling is not a painless procedure. In recent studies it has been shown that a form of lidocaine has the efficacy which is similar to EMLA, for prevention of pain associated with EMG needling. The aim of this study was to evaluate the efficacy of Lidocaine H ointment in alleviating the pain caused by EMG needling. This study was performed on patients referred to Shohadaye Tajrish Hospital for EDx study in APR 2009- APR 2010. A double blinded, placebo controlled study was performed in 47 adult patients [94 lower limbs] to compare the pain of EMG needling into the tibialis anterior muscle after application of lidocaine-H ointment or placebo. Pain scores were obtained by using visual analog scale [VAS]. Experimental and placebo groups were compared with Mann-U-Whitney and Chi-square tests. The study was performed on 47 patients, 38.3% male and 61.7% female, mean age being 45.5 +/- 16.4years. Median VAS score was 4.66 +/- 2.14 vs. 6.11 +/- 2.07, [P<0.05]. 51.1% of patients in experimental group as compared to 21.3% in controls reported mild pain [VAS < 4], [P<0/01]. It seems that lidocaine-H ointment has beneficial effects in prevention of the pain associated with EMG needling