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Usefulness of quantitative EMG analysis in the differential diagnosis of neuromuscular diseases
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DELAY IN T H E T H A L A M O - C O R T I C A L IX)OP IN ANTERIOR HORN CELL DISI~)tSE. V. Natarajan, J. Paul and Z.A. Sayecd
turns and area, interference pattern amplitude density and other descriptors. The E M G analysis program employed offers a printed report with the s u m m a r y of significant findings, the values of analysed parameters and preliminary diagnostic conclusions.
(Government General llospital, Madras, India) ELECTROMYOGRAPHIC STUDIES IN POST1NSULT SPASTICffY. Somatosensory evoked potentials were studied in patients with anterior horn cell disease with and without associated pyramidal signs. Fourteen patients with anterior horn cell involvement and with no clinical sensory deficit were evaluated. The SEPs were studied in these patients using a Medelec MS6 by stimulating the posterior tibial nerve at the anke and the median nerve at the wrist and recording over the corresponding area on the cortex. The N19, P22 potentials on median nerve stimulation and N37, P40 potentials on posterior tibial nerve stimulalion were studied. The interlatency interval of N37 and P40 and to a lesser extent N19 and P22 potentials were observed to be prolonged. This observation raises the possibility of a thalamo-cortical loop involvement in anterior horn cell disease.
ORGANITATION O F BRAIN ELECTRIAI. ACTIVITY RFFLECTING LONG-LAS'TING PHYSIOLOGICAL READJUSTMENT AFTER INTEROC EIrI'IVE INFLUENCES.
N. Nukoesvski (First Neurological Clinical Medical Academy) A n u m b e r of electromyographic reflex methods and vibratory inhibition of the tt-reflex and a pair of I l-reflexes have been applied to 60 patients with postinsult spastic pareses and a control group of 30 adult persons for the purpose of elucidating the significance of certain electromyographic indicators of reflex activity. We are particularly interested in proprioceptive activity under the impact of vibration as a functional and quantitative evaluation of spastically increased muscle tone in postinsult pareses. We have established that for a functional and quantitative characterization of postinsult spastic pareses a battery of electrophysiological reflex methods is necessary (the ratios t t / M , A / M , I t / M with Jendrassik manoeuvre, and vibratory inhibition of the llreflexes. Of these, vibration is one of the most useful stimuli and should find its place in electromyographic practice.
N.D. Nikolov EEG MAPPING IN EPILEPSY: ICTAL AND INTERICTAL FINDINGS. (Brain Research Institute, Sofia, Bulgaria) L.F.V. Oiler, A. Russi and L. Oller-Daurella The study is based on the concept, that interoceptive influences lead to nonspecific, late and long-lasting after-effects in the electrical activity of the CNS, which play an important role for maintenance and improvement of the functional state of the brain in physiological frames (Varbanova 1967, Varbanova, Nikolov, 1982). O u r studies of the local and spatial processes of organization of brain electrical activity showed that two of the electrical p h e n o m e n a are of essential importance: the imposition of a c o m m o n rhythmic pattern around 3011z in different parts of the nervous system and a process of equalization of the level of mean coherence toward those pairs of structures which act as a definite functional assembly. Moreover, it was proved that these p h e n o m e n a are not species specific (they develop in cats, rats and in h u m a n beings) and that they have more generalized character, because they can be triggered also in different adaptive reactions of the organism following internal or external influences. All this gives us the opportunity to consider that the studied E E G p h e n o m e n a are connected with readjustment processes in the nervous system associated with adaptability to short- or long-lasting requirements in the physiological frames.
USEFULNESS O F QUANTITATIVE E M G ANALYSIS IN THE DIFFERENTIAL DIAGNOSIS O F N E U R O M U S C U L A R DISEASES.
(Centro Antiepileptico, Barcelona, Spain) We have analysed a total of 70 ictal F~EG epileptic recordings free of artifacts, corresponding to generalized and partial seizures, especially typical and atypical absences, myoclonic jerks, tonic seizures, and simple partial and complex partial seizures in different patterns. The purpose was to establish a relationship between the ictal clinical data, and the corresponding E E G mapping findings in order to derive some physiopathological considerations of each kind of seizure. We have also analysed 300 interictal E E G mapping recordings, corresponding tol00 generalized primary epilepsies, 100 generalized symptomatic epilepsies and 100 partial epilepsies. All these interictal E E G records contain specific E E G abnormalities (spike and wave complex, focal spikes, etc) and the aim of this statistical study was to obtain an E E G mapping pattern for each type of epilepsy.
SOMATOSENSORY AND M O T O R EVOKED POTENTIALS IN SPINAL DEGENERATIVE DISK DISEASE AND ~gTI'ENOSIS AT CERVICAL AND LUMBAR LEVEL. A. Pansini, G. De Luca, P. Lo Re, P. Conti, R. Conti, F. Bono, P. Gallina, A. Caprio and G. Pellicano
A. Nodarse and J. Mascaros (Florence University, Florence, Italy) (Institute of Neurology and Neurosurgcry, tlavana, Cuba) A blind E M G study has been carried out in 30 selected patients with neuromuscular disease. Concentric needle E M G with automatic acquisition and analysis of individual motor unit potentials at low intensity contraction as well as the interference pattern at maximum voluntary effort were performed using a computer-aided method for E M G analysis developed in o u r laboratory. Both the single M U P and the interference pattern analysis method classified every patient in one of three different groups: motor neuron disease; peripheral neuropathy; myopathy, according to such parameters as M U P duration, amplitude,
Somatosensory evoked potentials (SEPs) have for many years been part of the basic diagnostic tests of medullar and radicular compressive pathology, supporting the traditional electromyographic methods and complementing the information obtained by them. We have begun to apply SEPs in cervical radicular pathology due to degenerative disk disease and intervertebral foraminal stenosis, objectively quantifying the variations in the conduction induced by surgical intervention. Recently we have extended the utilization of this method also in lumbar radicular compression, registering also intra-operatively the
DELAY IN T H E T H A L A M O - C O R T I C A L IX)OP IN ANTERIOR HORN CELL DISI~)tSE. V. Natarajan, J. Paul and Z.A. Sayecd
turns and area, interference pattern amplitude density and other descriptors. The E M G analysis program employed offers a printed report with the s u m m a r y of significant findings, the values of analysed parameters and preliminary diagnostic conclusions.
(Government General llospital, Madras, India) ELECTROMYOGRAPHIC STUDIES IN POST1NSULT SPASTICffY. Somatosensory evoked potentials were studied in patients with anterior horn cell disease with and without associated pyramidal signs. Fourteen patients with anterior horn cell involvement and with no clinical sensory deficit were evaluated. The SEPs were studied in these patients using a Medelec MS6 by stimulating the posterior tibial nerve at the anke and the median nerve at the wrist and recording over the corresponding area on the cortex. The N19, P22 potentials on median nerve stimulation and N37, P40 potentials on posterior tibial nerve stimulalion were studied. The interlatency interval of N37 and P40 and to a lesser extent N19 and P22 potentials were observed to be prolonged. This observation raises the possibility of a thalamo-cortical loop involvement in anterior horn cell disease.
ORGANITATION O F BRAIN ELECTRIAI. ACTIVITY RFFLECTING LONG-LAS'TING PHYSIOLOGICAL READJUSTMENT AFTER INTEROC EIrI'IVE INFLUENCES.
N. Nukoesvski (First Neurological Clinical Medical Academy) A n u m b e r of electromyographic reflex methods and vibratory inhibition of the tt-reflex and a pair of I l-reflexes have been applied to 60 patients with postinsult spastic pareses and a control group of 30 adult persons for the purpose of elucidating the significance of certain electromyographic indicators of reflex activity. We are particularly interested in proprioceptive activity under the impact of vibration as a functional and quantitative evaluation of spastically increased muscle tone in postinsult pareses. We have established that for a functional and quantitative characterization of postinsult spastic pareses a battery of electrophysiological reflex methods is necessary (the ratios t t / M , A / M , I t / M with Jendrassik manoeuvre, and vibratory inhibition of the llreflexes. Of these, vibration is one of the most useful stimuli and should find its place in electromyographic practice.
N.D. Nikolov EEG MAPPING IN EPILEPSY: ICTAL AND INTERICTAL FINDINGS. (Brain Research Institute, Sofia, Bulgaria) L.F.V. Oiler, A. Russi and L. Oller-Daurella The study is based on the concept, that interoceptive influences lead to nonspecific, late and long-lasting after-effects in the electrical activity of the CNS, which play an important role for maintenance and improvement of the functional state of the brain in physiological frames (Varbanova 1967, Varbanova, Nikolov, 1982). O u r studies of the local and spatial processes of organization of brain electrical activity showed that two of the electrical p h e n o m e n a are of essential importance: the imposition of a c o m m o n rhythmic pattern around 3011z in different parts of the nervous system and a process of equalization of the level of mean coherence toward those pairs of structures which act as a definite functional assembly. Moreover, it was proved that these p h e n o m e n a are not species specific (they develop in cats, rats and in h u m a n beings) and that they have more generalized character, because they can be triggered also in different adaptive reactions of the organism following internal or external influences. All this gives us the opportunity to consider that the studied E E G p h e n o m e n a are connected with readjustment processes in the nervous system associated with adaptability to short- or long-lasting requirements in the physiological frames.
USEFULNESS O F QUANTITATIVE E M G ANALYSIS IN THE DIFFERENTIAL DIAGNOSIS O F N E U R O M U S C U L A R DISEASES.
(Centro Antiepileptico, Barcelona, Spain) We have analysed a total of 70 ictal F~EG epileptic recordings free of artifacts, corresponding to generalized and partial seizures, especially typical and atypical absences, myoclonic jerks, tonic seizures, and simple partial and complex partial seizures in different patterns. The purpose was to establish a relationship between the ictal clinical data, and the corresponding E E G mapping findings in order to derive some physiopathological considerations of each kind of seizure. We have also analysed 300 interictal E E G mapping recordings, corresponding tol00 generalized primary epilepsies, 100 generalized symptomatic epilepsies and 100 partial epilepsies. All these interictal E E G records contain specific E E G abnormalities (spike and wave complex, focal spikes, etc) and the aim of this statistical study was to obtain an E E G mapping pattern for each type of epilepsy.
SOMATOSENSORY AND M O T O R EVOKED POTENTIALS IN SPINAL DEGENERATIVE DISK DISEASE AND ~gTI'ENOSIS AT CERVICAL AND LUMBAR LEVEL. A. Pansini, G. De Luca, P. Lo Re, P. Conti, R. Conti, F. Bono, P. Gallina, A. Caprio and G. Pellicano
A. Nodarse and J. Mascaros (Florence University, Florence, Italy) (Institute of Neurology and Neurosurgcry, tlavana, Cuba) A blind E M G study has been carried out in 30 selected patients with neuromuscular disease. Concentric needle E M G with automatic acquisition and analysis of individual motor unit potentials at low intensity contraction as well as the interference pattern at maximum voluntary effort were performed using a computer-aided method for E M G analysis developed in o u r laboratory. Both the single M U P and the interference pattern analysis method classified every patient in one of three different groups: motor neuron disease; peripheral neuropathy; myopathy, according to such parameters as M U P duration, amplitude,
Somatosensory evoked potentials (SEPs) have for many years been part of the basic diagnostic tests of medullar and radicular compressive pathology, supporting the traditional electromyographic methods and complementing the information obtained by them. We have begun to apply SEPs in cervical radicular pathology due to degenerative disk disease and intervertebral foraminal stenosis, objectively quantifying the variations in the conduction induced by surgical intervention. Recently we have extended the utilization of this method also in lumbar radicular compression, registering also intra-operatively the