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Objective To investigate the diagnostic value of spontaneous activities in genioglossus of amyotrophic lateral sclerosis (ALS).Methods A retrospective analysis of 79 patients diagnosed with ALS from January 2014 to December 2015 in Beijing Tiantan Hospital Affiliated to Capital Medical University was made.The patients were divided into two groups according to the clinical examination:with (44 patients) or without bulbar symptoms (35 patients).The course of disease,spontaneous potentials and ALS-Functional Rating Scale (ALS-FRS) scores were discussed,together with the association between semi-quantitative evaluation of spontaneous potential of the genioglossus and ALS-FRS score.Results In ALS patients,the overall positive rate of glossal spontaneous potentials was 69.6％ (55/79),among which the positive rate was 82.9％ (29/35) in patients with bulbar symptoms and 59.1％ (26/44) in patients without bulbar symptoms,with statistically significant differences between the two groups (x2=5.206,P＜0.05).While the positive rate in sternocleidomastoid was only 13.9％ (11/79),and there was no statistically significant difference between patients with or without bulbar symptoms.Semi-quantitative evaluation of fibrillation potentials in genioglossus muscle was correlated with ALS-FRS score (r=-0.258,P＜0.05).Conclusion Compared with sternocleidomastoid muscle,genioglossus muscle has a higher positive rate of spontaneous potentials and a higher diagnostic value in patients with subclinical bulbar symptoms.
RESUMO
Objective To optimize the method to elicit the facial nerve F wave and to establish its reference values and its related parameters, in order to provide an electrophysiological basis for facial nerve assessment in patients with hemifacial spasm (HFS). Methods Thirty-six healthy volunteers and 22 patients with HFS underwent this project. Compound muscle action potentials (CAMP, or M waves) and F waves were elicited by stimulating the marginal mandibular branch of the facial nerve and recorded with needle electrodes placed in the mentalis muscle. The association between F parameters and Cohen Grading of the HFS patients were analyzed. Results There were no significant differences in F parameters between men and women or between the two sides in control subjects. Minimal latency of F wave (Fmin) and mean latency of F wave (Fmean) had positive correlations with head circumference (Fmin r=0.449, P=0.013; Fmean r=0.391, P=0.033), but had no correlations with age nor height. Patients with HFS had prolonged duration of F wave (Fdura) in spasm side, compared with normal side (13.1 ms vs. 9.5 ms, P<0.01) and healthy subjects (13.1 ms vs. 9.7 ms, P<0.001), and increased ratio of F-wave amplitude and M-wave amplitude (F/M) in spasm side, compared with normal side (6.9% vs. 3.8%, P<0.001) and healthy subjects (6.9% vs. 3.7%, P<0.001). F/M exhibited a positive correlation with Cohen Grading (r=0.538, P=0.001). Conclusion A clear facial nerve F wave can be achieved by stimulating the marginal mandibular branch of the facial nerve, which provides an objective basis for evaluation of the facial nerve function in HFS patients with increased F/M and prolonged Fdura.