Cullen M O'gorman1, Janneke G Weikamp2, Michael Baria3, Lenie Van Den Engel-Hoek2, Charles Kassardjian1, Nens Van Alfen4, Andrea J Boon1,5. 1. Department of Neurology, Mayo Clinic, Rochester, Minnesota, 55905, USA. 2. Department of Rehabilitation, Donders Centre for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands. 3. Department of Physical Medicine and Rehabilitation, The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. 4. Department of Neurology and Clinical Neurophysiology, Donders Center for Neuroscience, Radboud University Medical Center, Nijmegen, The Netherlands. 5. Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, Minnesota, USA.
Abstract
INTRODUCTION: Cranial muscle fasciculations may be difficult to detect in amyotrophic lateral sclerosis (ALS). Ultrasound (US) detection of fasciculations in these muscles may have clinical utility. METHODS: Patients with suspected ALS were prospectively enrolled. Nerve conduction studies, needle electromyography (EMG), and US examination of cranial muscles were performed. Controls were examined by US only. Fasciculations were counted and scored for each muscle after 10 or 30 seconds. RESULTS: There were 84 patients with ALS. Fasciculations were most frequently found in the genioglossus muscle. Overall, detection rates by US and EMG were similar, but US was more likely to detect frequent fasciculations. Fasciculations were rare in controls, seen in 7 of 1,090 (0.6%) muscles. No control had > 5 fasciculations in any muscle. DISCUSSION: Fasciculations were frequently detected in cranial muscles of patients with ALS. US was found to be a sensitive method, and was not impaired by factors such as anxiety and the inability of the patient to relax. Muscle Nerve 56: 1072-1076, 2017.
INTRODUCTION: Cranial muscle fasciculations may be difficult to detect in amyotrophic lateral sclerosis (ALS). Ultrasound (US) detection of fasciculations in these muscles may have clinical utility. METHODS:Patients with suspected ALS were prospectively enrolled. Nerve conduction studies, needle electromyography (EMG), and US examination of cranial muscles were performed. Controls were examined by US only. Fasciculations were counted and scored for each muscle after 10 or 30 seconds. RESULTS: There were 84 patients with ALS. Fasciculations were most frequently found in the genioglossus muscle. Overall, detection rates by US and EMG were similar, but US was more likely to detect frequent fasciculations. Fasciculations were rare in controls, seen in 7 of 1,090 (0.6%) muscles. No control had > 5 fasciculations in any muscle. DISCUSSION: Fasciculations were frequently detected in cranial muscles of patients with ALS. US was found to be a sensitive method, and was not impaired by factors such as anxiety and the inability of the patient to relax. Muscle Nerve 56: 1072-1076, 2017.
Authors: C E McIlduff; M G Martucci; C Shin; K Qi; A K Pacheck; H Gutierrez; M Mortreux; S B Rutkove Journal: Clin Neurophysiol Date: 2020-07-17 Impact factor: 3.708