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Sensitivity for detecting fibrillation potentials: a comparison between concentric and monopolar needle electrodes.
H B Sherman1, F O Walker, P D Donofrio
1Department of Neurology, Wake Forest University, Bowman Gray School of Medicine, Winston-Salem, North Carolina 27103.
Muscle & Nerve
|November 1, 1990
Summary
Concentric needles detected slightly more fibrillation potentials (FP) than monopolar needles, but this difference did not impact diagnosis. Concentric needles were also reported as more painful, possibly due to increased tissue injury.
Area of Science:
- Neurology
- Electrophysiology
Background:
- Fibrillation potentials (FP) are indicators of denervation in neuromuscular disorders.
- The comparative sensitivity of monopolar and concentric needle electrodes for FP detection is not well-established.
Purpose of the Study:
- To formally compare the sensitivity of monopolar versus concentric needle electrodes in detecting fibrillation potentials.
- To assess the impact of electrode type on diagnostic interpretation and patient discomfort.
Main Methods:
- 35 muscles with FP were studied, with 20 sites sampled per muscle using both concentric and monopolar needles.
- Needle movement artifact generation of FP was also investigated in 25 additional muscles.
Main Results:
- Concentric needles identified a statistically significant, though small, increase in FP detection sites compared to monopolar needles (0.88 +/- 3.44).
- This difference did not alter diagnostic interpretations.
- Patients reported greater discomfort with concentric needles, and needle movement was identified as a major source of FP.
Conclusions:
- While concentric needles show slightly higher sensitivity for FP detection, the clinical significance is minimal.
- Increased tissue injury from concentric needles may contribute to both higher sensitivity and patient discomfort.