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Pseudo-quadriceps sparing in multiple sclerosis
N Levin1, A Vaknin-Dembinsky, P Petrou
1Department of Neurology and the Agnes-Ginges Center for Neurogenetics, Hadassah-Hebrew University Hospital, Jerusalem, Israel.
European Journal of Neurology
|August 13, 2011
Summary
In multiple sclerosis (MS), the quadriceps muscle is notably spared despite significant weakness in the iliopsoas muscle. This finding offers insights into MS motor disability assessment.
Area of Science:
- Neurology
- Muscle Physiology
Background:
- Differential muscle involvement is observed in various myopathies.
- Such specific muscle group involvement patterns have not been previously described in multiple sclerosis (MS) or general pyramidal syndromes.
Purpose of the Study:
- To investigate the differential involvement of distinct muscle groups in patients with chronic pyramidal syndrome caused by MS.
- To compare muscle power in the quadriceps and iliopsoas muscles in MS patients.
Main Methods:
- Muscle power was assessed in 127 patients with chronic MS-related pyramidal syndrome.
- A control group of 37 patients with acute or chronic paraparesis from other causes was included for comparison.
Main Results:
- Patients with MS showed significantly weaker iliopsoas muscles (1.68±1.1) compared to their quadriceps muscles (4.06±1.4).
- The control group exhibited no significant difference in muscle power between the iliopsoas (2±1.2) and quadriceps (2.4±1.4) muscles.
Conclusions:
- The quadriceps muscle remains relatively spared in MS patients, even with severe, long-standing paraparesis.
- Potential neuroanatomical, neurophysiological, and rehabilitational factors may explain this sparing.
- This observation could lead to improved scales for assessing motor disability and disease progression in MS.
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