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Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis
Published on: March 4, 2014
Electrodiagnosis in persons with amyotrophic lateral sclerosis
Nanette C Joyce1, Gregory T Carter
1Department of Physical Medicine and Rehabilitation, University of California, Davis School of Medicine, 4860 Y St, Suite 3850, Sacramento, CA 95817, USA. Nanette.joyce@ucdmc.ucdavis.edu
PM & R : the Journal of Injury, Function, and Rehabilitation
|March 26, 2013
Summary
Electrophysiology is crucial for diagnosing amyotrophic lateral sclerosis (ALS). Recent criteria elevate the importance of fasciculation potentials in needle electromyography, equating electrophysiologic findings with clinical signs for ALS diagnosis.
Area of Science:
- Neurology
- Clinical Neurophysiology
Background:
- Motor neuron disease diagnosis relies heavily on electrophysiology.
- Peripheral nerve conduction studies and needle electromyography are essential for differential diagnosis and ALS evaluation.
Purpose of the Study:
- To review the role of electrodiagnostic studies in evaluating motor neuron disease.
- To discuss updated diagnostic criteria for amyotrophic lateral sclerosis (ALS) and the significance of electrophysiologic findings.
Main Methods:
- Review of electrophysiologic techniques in ALS diagnosis.
- Analysis of revised El Escorial criteria and the Awaji-shima consensus recommendations.
Main Results:
- Fasciculation potentials now hold diagnostic significance equal to fibrillation and positive sharp waves in needle EMG for ALS.
- Electrophysiologic evidence is considered equivalent to clinical findings for establishing an ALS diagnosis.
Conclusions:
- Electrophysiology, particularly needle EMG, is a cornerstone in diagnosing ALS.
- Updated criteria enhance the diagnostic power of electrophysiologic findings in suspected ALS cases.
