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P73-F Electroneurographic parameters in ALS patients
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Abstracts / Clinical Neurophysiology 130 (2019) e21–e116
Materials and methods: VEMP studies performed in patients diagnosed with unilateral younger than 60 years old and done between 2014 and 2017 were analysed. VEMPs were recorded from the ipsilateral sternocleidomastoid muscle (cVEMP) and periocular sites (oVEMP). 500 Hz tone burst at 105 dB nHL was used as stimuli at 5 Hz stimulation rate and averaged for 200 repetitions. Bandpassfiltered between 20 Hz and 2 kHz. Statistical analysis included paired sample test in the SPSS program. We compared latency and amplitude of the affected side (AS) with healthy side (HS). Results: We included 9 patients, mean age 48.7 ± 6.8 years old. Patients without bilateral response (1 in cVEMP, 2 in oVEMP), were not included in the statistical analysis of its category. In 87.5% of the cases, p13 latency was longer in AS (13.5–21.1 ms) vs HS (12.9–15.9 ms, p = .017 Wilcoxon test). No statistically significant differences were obtained in the remaining parameter. Conclusion: The p13 latency of cVEMP is longer on the affected side with compared to the contralateral healthy side. Since VEMP test clinically evaluates the otolithic function, it is not invasive and is well tolerated, its use should be extended. doi:10.1016/j.clinph.2019.04.520
P72-F Electromyography in the course of amyotrophic lateral sclerosis—Ilona Hübner a,*, Jacek Hübner a, n. med. Sławomir Kroczka b (a Laboratory of Neurophysiology, Neurology Unit, District Hospital in Radomsko, Radomsko, Poland, b Laboratory of Neurophysiology, Chair of Child and Youth Neurology Collegium Medicum, Jagiellonian University in Krakow, Krakow, Poland) ⇑
Corresponding author.
Background: Amyotrophic lateral sclerosis is a progressive, incurable neurodegenerative disease resulting in neurogenic muscle damage. Material and methods: The study covered 20 patients – 5 women and 15 men aged 43–85; 65.5 on average. The group included patients with clinically proven or probable ALS diagnosis established based on the modified El Escorial criteria. The study was performed three times with three-month long intervals. Muscles from three layers of the central nervous system were subject to analysis: bulbs (muscle of the tongue), cervical (left biceps brachii – BB and left first dorsal interosseous – FDI), sacrolumbar (right vastus lateralis – VL and right tibialis anterior – TA). Resting activity and MUP parameters (amplitude, area, duration, size index – SI) were evaluated. Results: Incorrect results most frequently concerned the amplitude, area, SI MUP – BB (100%), FDI (100% – SI; 95% – the MUP amplitude; 90% – the MUP area), VL (90% – the MUP amplitude and area; 80% – SI), TA (95% – SI; 85% – the MUP amplitude and area) and duration – BB (85%), FDI (90%). Moreover, at rest, the majority of patients had, in all the muscles subject to the study, their active denervation potentials recorded, i.e. fibrillation or positive slow waves. Significant differences were observed within the course of a sixmonth period as regards the measurements concerning the duration of MUP of the muscles subject to the study (prolonged duration of MUP). Conclusion: Neurogenic lesions are already present at the time of ALS diagnosis.Relationship was observed between motor neurons loss and the gradually increasing duration of MUP of particular muscles in the course of ALS. doi:10.1016/j.clinph.2019.04.521
P73-F Electroneurographic parameters in ALS patients—Jacek Hübner a,*, Ilona Hübner a, Sławomir Kroczka b (a Laboratory of Neurophysiology, Neurology Unit, District Hospital in Radomsko, Radomsko, Poland , b Laboratory of Neurophysiology, Chair of Child and Youth Neurology Collegium Medicum, Jagiellonian University in Krakow, Krakow, Poland) ⇑
Corresponding author.
Background: Amyotrophic lateral sclerosis is an incurable neurodegenerative disease characterised by intensifying motor conduction disorders. Material and methods: The study covered 20 people (5 women, 15 men; aged 65.5 ± 20) with clinically proven or probable ALS diagnosis established based on El Escorial criteria. The patients were subject to examination three times over a six-month period. Motor conduction was assessed in both the median nerves and ulnar nerves. In each case, the speed of conduction, terminal latency, compound muscle action potential (CMAP) amplitude, and minimal F wave latency were assessed. Results: Incorrect values were most often observed in the CMAP amplitude: left median nerve in 70%, right median nerve in 70%; left ulnar nerve in 40%; right ulnar nerve in 35%. In subsequent measurements, the CMAP amplitude of the left median nerve and both ulnar nerves was lower than during the preliminary measurement. Conclusion: Motor conduction disorders are already present at the time of diagnosis. There is a marked dependence of motor cell loss of the anterior horns of the spinal cord on intensified motor conduction changes. doi:10.1016/j.clinph.2019.04.522
P74-F Vestibular evoked myogenic potentials and their clinical utility in patients with amyotrophic lateral sclerosis—Xiaoxuan Liu, Dongsheng Fan (Peking University Third Hospital, Beijing, China)
Background: To evaluate the diagnostic value of vestibular evoked myogenic potentials (VEMPs) in the assessment of brainstem function integrity in patients with amyotrophic lateral sclerosis (ALS). Materials and methods: This was a prospective case-control study including 30 definite or probable ALS patients divided into two groups (with or without brainstem involvement) and 30 healthy controls. Cervical (c-), masseter (m-) and ocular VEMP (o-VEMP) measurements were obtained for all the participants. Results: The c-VEMP mean p13 and n23 were significantly prolonged in the ALS patients. The interside peak differences in p13 and n23 of c-VEMP and in n10 and p15 of o-VEMP were significantly prolonged. The rates of alteration in c-VEMP, m-VEMP and o-VEMP in the ALS patients were 67%, 40%, and 45%, respectively. The ALS patients with brainstem involvement had a significantly higher percentage of VEMP abnormalities than did those without brainstem involvement (p = 0.027). Conclusions: c-VEMP is a sensitive tool to detect lower levels of brainstem involvement. Impairments in o-VEMP and m-VEMP indicate involvement of the upper brainstem. The use of combined VEMPs may provide useful insights into the pathophysiological mechanism of ALS. VEMPs may be useful in the evaluation of brainstem dysfunction in ALS patients. doi:10.1016/j.clinph.2019.04.523
Abstracts / Clinical Neurophysiology 130 (2019) e21–e116
Materials and methods: VEMP studies performed in patients diagnosed with unilateral younger than 60 years old and done between 2014 and 2017 were analysed. VEMPs were recorded from the ipsilateral sternocleidomastoid muscle (cVEMP) and periocular sites (oVEMP). 500 Hz tone burst at 105 dB nHL was used as stimuli at 5 Hz stimulation rate and averaged for 200 repetitions. Bandpassfiltered between 20 Hz and 2 kHz. Statistical analysis included paired sample test in the SPSS program. We compared latency and amplitude of the affected side (AS) with healthy side (HS). Results: We included 9 patients, mean age 48.7 ± 6.8 years old. Patients without bilateral response (1 in cVEMP, 2 in oVEMP), were not included in the statistical analysis of its category. In 87.5% of the cases, p13 latency was longer in AS (13.5–21.1 ms) vs HS (12.9–15.9 ms, p = .017 Wilcoxon test). No statistically significant differences were obtained in the remaining parameter. Conclusion: The p13 latency of cVEMP is longer on the affected side with compared to the contralateral healthy side. Since VEMP test clinically evaluates the otolithic function, it is not invasive and is well tolerated, its use should be extended. doi:10.1016/j.clinph.2019.04.520
P72-F Electromyography in the course of amyotrophic lateral sclerosis—Ilona Hübner a,*, Jacek Hübner a, n. med. Sławomir Kroczka b (a Laboratory of Neurophysiology, Neurology Unit, District Hospital in Radomsko, Radomsko, Poland, b Laboratory of Neurophysiology, Chair of Child and Youth Neurology Collegium Medicum, Jagiellonian University in Krakow, Krakow, Poland) ⇑
Corresponding author.
Background: Amyotrophic lateral sclerosis is a progressive, incurable neurodegenerative disease resulting in neurogenic muscle damage. Material and methods: The study covered 20 patients – 5 women and 15 men aged 43–85; 65.5 on average. The group included patients with clinically proven or probable ALS diagnosis established based on the modified El Escorial criteria. The study was performed three times with three-month long intervals. Muscles from three layers of the central nervous system were subject to analysis: bulbs (muscle of the tongue), cervical (left biceps brachii – BB and left first dorsal interosseous – FDI), sacrolumbar (right vastus lateralis – VL and right tibialis anterior – TA). Resting activity and MUP parameters (amplitude, area, duration, size index – SI) were evaluated. Results: Incorrect results most frequently concerned the amplitude, area, SI MUP – BB (100%), FDI (100% – SI; 95% – the MUP amplitude; 90% – the MUP area), VL (90% – the MUP amplitude and area; 80% – SI), TA (95% – SI; 85% – the MUP amplitude and area) and duration – BB (85%), FDI (90%). Moreover, at rest, the majority of patients had, in all the muscles subject to the study, their active denervation potentials recorded, i.e. fibrillation or positive slow waves. Significant differences were observed within the course of a sixmonth period as regards the measurements concerning the duration of MUP of the muscles subject to the study (prolonged duration of MUP). Conclusion: Neurogenic lesions are already present at the time of ALS diagnosis.Relationship was observed between motor neurons loss and the gradually increasing duration of MUP of particular muscles in the course of ALS. doi:10.1016/j.clinph.2019.04.521
P73-F Electroneurographic parameters in ALS patients—Jacek Hübner a,*, Ilona Hübner a, Sławomir Kroczka b (a Laboratory of Neurophysiology, Neurology Unit, District Hospital in Radomsko, Radomsko, Poland , b Laboratory of Neurophysiology, Chair of Child and Youth Neurology Collegium Medicum, Jagiellonian University in Krakow, Krakow, Poland) ⇑
Corresponding author.
Background: Amyotrophic lateral sclerosis is an incurable neurodegenerative disease characterised by intensifying motor conduction disorders. Material and methods: The study covered 20 people (5 women, 15 men; aged 65.5 ± 20) with clinically proven or probable ALS diagnosis established based on El Escorial criteria. The patients were subject to examination three times over a six-month period. Motor conduction was assessed in both the median nerves and ulnar nerves. In each case, the speed of conduction, terminal latency, compound muscle action potential (CMAP) amplitude, and minimal F wave latency were assessed. Results: Incorrect values were most often observed in the CMAP amplitude: left median nerve in 70%, right median nerve in 70%; left ulnar nerve in 40%; right ulnar nerve in 35%. In subsequent measurements, the CMAP amplitude of the left median nerve and both ulnar nerves was lower than during the preliminary measurement. Conclusion: Motor conduction disorders are already present at the time of diagnosis. There is a marked dependence of motor cell loss of the anterior horns of the spinal cord on intensified motor conduction changes. doi:10.1016/j.clinph.2019.04.522
P74-F Vestibular evoked myogenic potentials and their clinical utility in patients with amyotrophic lateral sclerosis—Xiaoxuan Liu, Dongsheng Fan (Peking University Third Hospital, Beijing, China)
Background: To evaluate the diagnostic value of vestibular evoked myogenic potentials (VEMPs) in the assessment of brainstem function integrity in patients with amyotrophic lateral sclerosis (ALS). Materials and methods: This was a prospective case-control study including 30 definite or probable ALS patients divided into two groups (with or without brainstem involvement) and 30 healthy controls. Cervical (c-), masseter (m-) and ocular VEMP (o-VEMP) measurements were obtained for all the participants. Results: The c-VEMP mean p13 and n23 were significantly prolonged in the ALS patients. The interside peak differences in p13 and n23 of c-VEMP and in n10 and p15 of o-VEMP were significantly prolonged. The rates of alteration in c-VEMP, m-VEMP and o-VEMP in the ALS patients were 67%, 40%, and 45%, respectively. The ALS patients with brainstem involvement had a significantly higher percentage of VEMP abnormalities than did those without brainstem involvement (p = 0.027). Conclusions: c-VEMP is a sensitive tool to detect lower levels of brainstem involvement. Impairments in o-VEMP and m-VEMP indicate involvement of the upper brainstem. The use of combined VEMPs may provide useful insights into the pathophysiological mechanism of ALS. VEMPs may be useful in the evaluation of brainstem dysfunction in ALS patients. doi:10.1016/j.clinph.2019.04.523