Laryngeal electromyography in amyotrophic lateral sclerosis. Issue 7 (21st April 2020)

• Record Type: Journal Article
• Authors: Martins, Melina Pazian; de Lima, Fabrício Diniz; Bernardes Leoni, Tauana; Martinez, Alberto R M; Nubiato Crespo, Agricio; André Teixeira Kimaid, Paulo; Nucci, Anamarli; de Carvalho, Mamede; França Jr, Marcondes C
• Is Part Of: Journal of neurology, neurosurgery and psychiatry. Volume 91:Issue 7(2020)
• Page Start: 730
• Page End: 732
• Publication Date: 2020-04-21
• Subjects: ALS -- EMG -- motor neuron disease; Neurology -- Periodicals; Nervous system -- Surgery -- Periodicals; Psychiatry -- Periodicals; 616.8
• DOI: 10.1136/jnnp-2020-322910
• Languages: English
• ISSNs: 0022-3050

Abstract

Abstract : Background: Bulbar involvement is a hallmark of amyotrophic lateral sclerosis (ALS), but surprisingly very few studies have addressed the frequency, pattern and clinical relevance of laryngeal involvement in the disease. Methods: Twenty-six patients with spinal-onset ALS underwent nasofibroscopy (NF), followed by laryngeal electromyography (LEMG). We also studied resting activity and motor unit potentials of the genioglossus and masseter muscles. Results: Twenty-four patients presented neurogenic changes in at least one laryngeal muscle. There were fibrillation and/or fasciculation potentials associated with chronic neurogenic changes in the same muscle in 16 patients; of these, 9 had no alteration in the genioglossus. We found no patient with tongue neurogenic changes and normal LEMG. NF was abnormal in 14 patients; in the remaining 12, LEMG identified neurogenic changes in 11 of them. Conclusion: LEMG is able to identify laryngeal denervation in patients with ALS, sometimes before clinical manifestations are noticed. This technique may be a useful diagnostic tool for selected patients with suspicion of ALS.