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Twitch mouth pressure for detecting respiratory muscle weakness in suspicion of neuromuscular disorder.
- Source :
-
Neuromuscular disorders : NMD [Neuromuscul Disord] 2017 Jun; Vol. 27 (6), pp. 518-525. Date of Electronic Publication: 2017 Feb 02. - Publication Year :
- 2017
-
Abstract
- Twitch mouth pressure using magnetic stimulation of the phrenic nerves and an automated inspiratory trigger is a noninvasive, non-volitional assessment of diaphragmatic strength. Our aims were to validate this method in patients with suspected neuromuscular disease, to determine the best inspiratory-trigger pressure threshold, and to evaluate whether twitch mouth pressure decreased the overdiagnosis of muscle weakness frequently observed with noninvasive volitional tests. Maximal inspiratory pressure, sniff nasal pressure, and twitch mouth pressure were measured in 112 patients with restrictive disease and suspected neuromuscular disorder. Esophageal and transdiaphragmatic pressures were measured in 64 of these patients to confirm or infirm inspiratory muscle weakness. Magnetic stimulation was triggered by inspiratory pressures of -1 and -5 cmH <subscript>2</subscript> O. The -5 cmH <subscript>2</subscript> O trigger produced the best correlation between twitch mouth pressure and twitch esophageal pressure (R <superscript>2</superscript> ā=ā0.86; Pā<0.0001). The best association of noninvasive tests to predict inspiratory muscle weakness was sniff nasal pressure and twitch mouth pressure. Below-normal maximal inspiratory pressure and sniff nasal pressure values suggesting inspiratory muscle weakness were found in 63/112 patients. Only 52 of these 63 patients also had abnormal twitch mouth pressure. In conclusion twitch mouth pressure measurement is a simple, noninvasive, nonvolitional technique which may help to select patients with suspected neuromuscular disorder for invasive inspiratory-muscle investigation.<br /> (Copyright © 2017 Elsevier B.V. All rights reserved.)
- Subjects :
- Adult
Diaphragm physiopathology
Esophagus physiopathology
Female
Humans
Inhalation
Male
Middle Aged
Mouth
Muscle Weakness complications
Muscle Weakness physiopathology
Neuromuscular Diseases complications
Neuromuscular Diseases physiopathology
Phrenic Nerve physiopathology
Pressure
Respiratory Muscles innervation
Sensitivity and Specificity
Muscle Weakness diagnosis
Neuromuscular Diseases diagnosis
Respiratory Function Tests methods
Respiratory Muscles physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-2364
- Volume :
- 27
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Neuromuscular disorders : NMD
- Publication Type :
- Academic Journal
- Accession number :
- 28318818
- Full Text :
- https://doi.org/10.1016/j.nmd.2017.01.022