http://www.ncbi.nlm.nih.gov/htbin-post/Entrez/query?uid=9808244&form=6&db=m&Dopt=b
J Neurol 1998 Nov;245(11):741-4
Can electromyography predict the prognosis of transverse
myelitis?
Misra UK, Kalita J
Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow,
India. ukmisra(AT)sgpgi.ren.nic.in
[Medline record in process]
The role of clinical and magnetic resonance imaging (MRI) features on the prognosis of acute
transverse myelitis has been studied, but the role of electromyography (EMG) changes, although
reported, has not been investigated. Seventeen patients with acute transverse myelitis were
subjected to clinical evaluation, MRI scanning and concentric needle EMG. The outcome was
defined on the basis of a 3-month Barthel Index (BI) score as good or poor. The EMG changes in
these groups were compared. All of the patients had complete paraplegia (power grade 0),
except 1 who had grade III power. Mild upper limb weakness was present in 6 patients. Joint
position and vibration sense were impaired in the lower limbs, and a horizontal limit to sensory
loss to pinprick was present in all of the patients. Spinal MRI was abnormal in 12 of 14 patients.
EMG of the lower limb muscles in the acute stage (within 15-30 days of onset) revealed
fibrillations or sharp waves or both in 11 patients. At 3-month follow-up, the lower limb power
had improved in 8 and upper limbs in all 6 patients. The EMG changes also improved in 6
patients; fibrillations either disappeared or were markedly reduced. The motor unit potentials
(MUPs) were of long duration, polyphasic with reduced recruitment. In 5 patients, however, no
MUPs could be recorded and fibrillations persisted. Lower limb hypotonia and fibrillations on
EMG were significantly related to the 3-month outcome. EMG evidence of denervation in the
lower limb muscles in acute transverse myelitis suggests a poor outcome as assessed by 3-month
Barthel index score.
PMID: 9808244, UI: 99023430