Avtor/Urednik     Podnar, Simon; Mrkaić, Mićo; Vodušek, David B
Naslov     Standardization of anal sphincter electromyography: quantification of continuous activity during relaxation
Tip     članek
Vir     Neurourol Urodyn
Vol. in št.     Letnik 21
Leto izdaje     2002
Obseg     str. 540-5
Jezik     eng
Abstrakt     Aims. Sphincter motor units (MUs) are continuously firing during relaxation. The quantification of this activity is a potentially useful electromyographic (EMG) parameter related to the number of MUs innervating the muscle and the level of motor neuron excitation. The aim of the present study was to develop a reliable, quantitative measure of continuous sphincter muscle activity during relaxation. Methods. EMG activity was analyzed during relaxation, 1 minute after insertion of the concentric needle electrode into four sites in the external anal sphineter (EAS) muscle. In 10 control subjects, 8 interference pattern samples were obtained by "turn/amplitude" analysis. In 35 control subjects, a multi-MUP count of continuously firing motor unit potentials (MUPs) was used, quadruplets with scores of 0-6 obtained, and the lower reference limits (95t6 percentile) calculated.This approach was then evaluated in 57 patients (182 muscles) with cauda equina or conus medullaris lesion (CECML) and 7 patients (13 muscles) with "idiopathic fecal incontinence." Results. The lower reference ("outlier") limits for MUP count were 0 0 6 6 and 0 1 2 2 for the subcutaneous, and 0 0 0 6 and 0 0 1 1 for the deeper EAS muscles. Both patient groups had a significantly diminished number of continuously firing MUPs, which was below the reference range in 43% of the EAS muscles from CECM patients and in 85% of muscles from patients with idiopathic fecal incontinence. In patients with CECML, the decrease in MUP count correlated with the severity of the lesion, as defined by the sensory deficit. Conclusions. MUP count in sphincter muscles during relaxation is technically feasible, and it is a promising tool, particularly in patients with idiopathic fecal incontinence.
Deskriptorji     CAUDA EQUINA
FECAL INCONTINENCE
ANUS
ELECTROMYOGRAPHY
LINEAR MODELS