Practical Approach to Electromyography

Siao, Peter; Cros, Didier; Vucic, Steve

doi:10.1891/9781617050053

Cited by 16 publications

(12 citation statements)

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“…A potential limitation of the split hand index may occur in the setting of coexistent focal pressure mononeuropathies, particularly carpal tunnel syndrome and ulnar neuropathy at the elbow. Clinical, neurophysiological, and radiological correlation should then be utilized to assess for a specific pattern of pathology and alternative techniques need to be implemented so as to establish a diagnosis of ALS 23,24 . In addition, the SI may be limited in advanced disease, when there may be global atrophy of intrinsic hand muscles.…”

Section: Discussionmentioning

confidence: 99%

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

Menon

Vucic

2014

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The split hand phenomenon refers to predominant wasting of thenar muscles and is an early and specific feature of amyotrophic lateral sclerosis (ALS). A novel split hand index (SI) was developed to quantify the split hand phenomenon, and its diagnostic utility was assessed in ALS patients. The split hand index was derived by dividing the product of the compound muscle action potential (CMAP) amplitude recorded over the abductor pollicis brevis and first dorsal interosseous muscles by the CMAP amplitude recorded over the abductor digiti minimi muscle. In order to assess the diagnostic utility of the split hand index, ALS patients were prospectively assessed and their results were compared to neuromuscular disorder patients. The split hand index was significantly reduced in ALS when compared to neuromuscular disorder patients (P<0.0001). Limb-onset ALS patients exhibited the greatest reduction in the split hand index, and a value of 5.2 or less reliably differentiated ALS from other neuromuscular disorders. Consequently, the split hand index appears to be a novel diagnostic biomarker for ALS, perhaps facilitating an earlier diagnosis.

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Section: Discussionmentioning

confidence: 99%

Utility of Dissociated Intrinsic Hand Muscle Atrophy in the Diagnosis of Amyotrophic Lateral Sclerosis

Menon

Vucic

2014

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“…NCS performed according to established techniques were retrospectively collected for all CIDP patients from review of records. Motor nerves studied were median, ulnar, tibial, and common fibular, while sensory nerves were median, ulnar, and sural.…”

Section: Methodsmentioning

confidence: 99%

Postural tremor and chronic inflammatory demyelinating polyneuropathy

et al. 2016

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“…The ability to effectively assess the biophysical properties of distal axonal segments may have pathophysiological significance in a variety of peripheral nerve disorders. Specifically, distal nerve segments appear to be preferentially affected in generalized neuropathies via a dying‐back process, whereby dysfunction of the distal axonal segments appears to be an early feature of the disease process 23. In addition, positive motor phenomena, such as fasciculations, may be generated distally 7, 24.…”

Section: Discussionmentioning

confidence: 99%

“…Of further relevance, assessment of the distal median nerve may also provide unique insights into the pathophysiology of carpal tunnel syndrome (CTS). Specifically, although the clinical features of CTS are well recognized, the precise pathophysiological mechanisms underlying CTS are not fully elucidated, with both mechanical compression and nerve ischemia proposed as possible pathophysiological mechanisms 9, 23, 32, 33. Interestingly, axonal excitability studies of the median nerve at the wrist in CTS patients have demonstrated varied results 34.…”

Section: Discussionmentioning

confidence: 99%