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To assess the rate of fibrillation and/or positive sharp waves (FPSW) in the paraspinal muscles (PM) of patients with chronic lumbosacral radiculopathy, PM and leg muscles of 179 patients, 111 men and 68 women, aged 24–68 years (mean 49.0 ± 9.3), were tested. Illness duration ranged from 8 months to 40 years (9.4 ± 7.5 years). FPSW were detected in 38 patients (21.2%). In 28 of them (15.6%), FPSW were present in the limb muscles only, in eight (4.5%) in both PM and limb muscles, and in two (1.1%) solely in the PM. FPSW were accompanied in all the above patients by chronic neurogenic changes of motor unit potentials. Logistic regression analysis did not show any significant difference between: (i) the patients with and without fibrillations in leg and/or PM muscles, and (ii) between those with FPSW in both the PM and leg muscles and those with FPSW in the leg muscles only, when the effect of age and duration of illness were considered. These suggest that the paucity of FPSW in the PM is rather genuine and does not depend on the timing of the examination. In consequence, PM electromyography seems to be not as valuable in chronic radiculopathy as it is in the acute stage. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To explore the presence and grade of denervation in three mimic muscles in facial nerve palsy. Methods: The frontalis, orbicularis oculi (OO), and mentalis muscles were explored in 54 patients with Bell''s palsy, after 30 days from the beginning of symptoms. Concentric needle electromyography, including fibrillation detection, was performed in the three muscles on the affected side. Compound muscle action potentials (CMAP) were recorded on both sides and a CMAP ratio was calculated from each muscle. The House–Brackman scale was used to assess the initial clinical evaluation and the follow-up until recovery. Results: Fibrillation was recorded in 32 patients on the 30th day after the onset and was present in 100% of mentalis and in 90% of frontalis, but in only 34% of OO, a statistically significant difference. The grade of fibrillation in OO was also statistically lower from those in the other two muscles. The 32 patients were grouped according to the presence (A) or not (B) of fibrillation in OO. In group A, CMAP ratios (affected/normal side) did not differ significantly among the three muscles. However, in group B they were significantly greater in OO and frontalis than in mentalis. In between-group comparison, group B muscles had significantly higher CMAP ratios, lower degree of fibrillation, and better functional recovery. Conclusion: In facial palsy, the presence and grade of fibrillation in OO are lower than in frontalis and mentalis muscles and prognosis is more favorable for the non-fibrillating OO group of patients. [Copyright &y& Elsevier]

Highlights • Q-EMG in myofibrillar myopathies is suggestive of a myopathic profile. • Longer MUP durations are associated with a larger fibre diameter variability. • Diameter of Type 1 muscle fibers is positively correlated with mean MUP amplitude. • Fibrillation potentials and positive sharp waves are uncommon. • Myotonic discharges are more frequent. [ABSTRACT FROM AUTHOR]

Purpose/aim of the study: An increased serum level of creatine kinase (CK) in asymptomatic individuals is a diagnostic challenge, as it may be associated with either physiological conditions, such as exercise or even signal an ominous neuromuscular disease at a presymptomatic stage. The electromyogram (EMG) and the muscle biopsy play a key role in the evaluation of asymptomatic hyperckemia. The objective of this study was to investigate asymptomatic individuals with increased CK levels.Materials and methods: We comparatively studied EMG, quantitative EMG and muscle biopsy in asymptomatic clinically normal individuals with repeatedly increased CK levels.Results: Conventional EMG was abnormal in 76% of patients, while quantitative EMG showed abnormal results in 88.9%. Muscle biopsy was diagnostic in 28%, one patient had neurogenic findings, 40% showed non-specific changes and 28% had normal results.Conclusions: EMG and especially quantitative EMG are highly sensitive in detecting subclinical neuromuscular diseases, whereas muscle biopsy may better contribute in the final diagnosis. No strong correlations were found between histological abnormalities and electrophysiological data, but further research is needed. [ABSTRACT FROM AUTHOR]

The article presents a case study of a woman, who was 26-year-old in 2003, and complained of oscillopsia and gait unsteadiness. Topics discussed include the consideration of a possible sporadic cerebellar degeneration disorder in the patient; the diagnosis of downbeat nystagmus and lower motor neuron disease in the patient; and the muscle biopsy of the patient, which was reminiscent of spinal muscular atrophy (SMA).

A letter to the editor is presented in response to an article on neuromyotonia and myasthenia gravis published in a previous issue of the periodical.

Abstract: Objectives: Mirror movements (MMs) are unintended and unnecessary movements accompanying voluntary activity in homologous muscles on the opposite side of the body, particularly in distal arm muscles. Congenital MMs may be sporadic or familial. Several mechanisms have been proposed to explain persistent congenital MMs. Hypothesis 1 assumes the existence of an ipsilateral corticospinal pathway, and Hypothesis 2 the activation of both motor cortices. We report a new case of congenital mirror movements in a healthy woman. Methods: Electromyographic recordings and focal transcranial magnetic stimulation (TMS) were used for neurophysiological evaluation. Results: Voluntary contraction of either abductor pollicis brevis (APB) elicited mirror activation of the other APB. Focal TMS of either M1 elicited motor evoked potential (MEP) of normal latency and amplitude in both resting APB. TMS of the left cortex upon maximal contraction of the right APB and mirror contraction of the left APB produced interhemispheric inhibition (IHI) in the former and silent period (SP) in the later. Conclusions: The electrophysiological evaluation using transcranial magnetic stimulation provides evidence of the concurrent action of both mechanisms in this patient. Significance: The combination of more than one hypothesis could be more appropriate for understanding the underlying mechanism in some MM cases. [ABSTRACT FROM AUTHOR]

Summary: Aims of the study: To detect amplitude differences between the sensory nerve action potentials (SNAP) obtained by simultaneous recording of the two main branches of the superficial peroneal sensory nerve (SPSN), the medial and intermediate dorsal cutaneous sensory nerves (MDCN, IDCN); to investigate whether these differences, if any, are correlated with gender, age, body mass index (BMI), and height of normal subjects; to discuss their clinical significance. Population and methods: Seventy-six healthy volunteers (36 males) were included (mean age: 36.5 years, range 20–80). Simultaneous MCND and IDCN recordings were performed via surface electrodes placed at precise positions on the intermalleolus line. Stimulation was performed 14cm proximally on two different sites over the anterolateral aspect of the right leg. Results: Responses were obtained for both nerve branches in all subjects. Median value and lower normal limit for the amplitude of the greater among both MDCN and IDCN responses was 10.95μV and 4.9μV, respectively. Statistically significant differences were found between the two branches in median amplitude and frequency of the greater value. These differences were not correlated with gender, age, BMI, or height. Conclusion: We propose simultaneous recording of the two main branches of the superficial peroneal sensory nerve, placing the recording electrodes and stimulation device on precise positions and measuring the amplitude of the best of both responses. This method is an improvement of an already existent one, and may be clinically useful in detecting abnormal responses of the SPSN. [Copyright &y& Elsevier]

A letter to the editor is presented in response to the article related to bilateral foot diseases as the caused of thoraic disc herniation.