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Syndrome of diffuse abnormal insertional activity: case report and family study
K C Wright1, R Ramsey-Goldman, V K Nielsen
1University of Pittsburgh Medical School, PA 15213.
Archives of Physical Medicine and Rehabilitation
|July 1, 1988
Summary
This study confirms a rare EMG finding of abnormal insertional activity without neuromuscular disease, observed in a family. The condition appears to be genetically inherited, emphasizing the need for electromyographers to recognize this benign entity.
Area of Science:
- Neurology
- Clinical Electrophysiology
Background:
- Wiechers and Johnson first described diffuse abnormal insertional activity on EMG in 1979.
- This activity was noted in the absence of any underlying neuromuscular disease.
Observation:
- A family presented with identical EMG findings to the original Wiechers and Johnson cohort.
- The propositus, a 53-year-old woman with back pain, showed trains of positive sharp waves with needle movement in all tested muscles.
Findings:
- Eight additional family members were screened, with four exhibiting the characteristic trains of positive sharp waves in all five tested muscles.
- Nerve conduction studies, radiographs, and laboratory tests were unremarkable in affected individuals.
- This is the first report to confirm Wiechers and Johnson's findings, suggesting a genetically transmitted abnormality.
Implications:
- The abnormal insertional activity appears to be inherited in an autosomal dominant pattern.
- While clinically insignificant, awareness of this EMG finding is crucial for electromyographers.
- Accurate identification prevents misdiagnosis of serious neuromuscular disorders.