期刊
MUSCLE & NERVE
卷 65, 期 3, 页码 311-316出版社
WILEY
DOI: 10.1002/mus.27480
关键词
ALS; CSA; MMN; selective muscle involvement
资金
- Japan Agency for Medical Research and Development [19K07966]
- [19ek0109252h0003]
- Grants-in-Aid for Scientific Research [19K07966] Funding Source: KAKEN
This study describes two new signs, weak shoulder and arm sparing signs, in amyotrophic lateral sclerosis (ALS). The weak shoulder sign is highly sensitive in ALS and specific when compared with multifocal motor neuropathy (MMN). The arm sparing sign is highly specific for ALS. These two new signs are promising as clinical clues in the diagnosis of ALS.
Introduction/Aims Various signs of selective involvement have been reported in amyotrophic lateral sclerosis (ALS). In this study, we describe two new signs, weak shoulder and arm sparing signs. Methods Subjects were retrospectively identified from our electrodiagnosis database. Medical Research Council scores of relevant muscles were evaluated. Weak shoulder was defined as the deltoid (Del) muscle being weaker than the biceps brachii (BB)/triceps brachii (TB) muscles; that is, Del was weaker than either or both of the muscles and no stronger than either. Arm sparing was defined as both Del and the first dorsal interosseous (FDI) being weaker than BB/TB. Sensitivities of these signs were compared with other signs of selective involvement. The specificities of these signs were investigated in patients with cervical spondylotic amyotrophy (CSA) and multifocal motor neuropathy (MMN). Results We reviewed 130 patients with ALS, 64 patients with CSA, and 16 patients with MMN. The weak shoulder and the arm sparing signs were observed in 73% and 55% of patients with ALS, 44% and 2% of patients with CSA (93% and 0% of patients with proximal CSA), respectively, and no patients with MMN. The sensitivity of the weak shoulder was higher than with conventional signs, whereas that of the arm sparing sign showed no difference. Discussion The weak shoulder sign was highly sensitive in ALS, and was specific when compared with MMN. The arm sparing sign was highly specific for ALS. These two new signs are promising as clinical clues in the diagnosis of ALS.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据