![]() Faszikulationen - Überblick über Pathophysiologic, klinische Bedeutung und Nachweis. Which muscle shows fasciculations by ultrasound in patients with ALS? J Med Invest. Dynamic muscle ultrasound - another extension of the clinical examination. Ultrasound-based detection of fasciculations in healthy and diseased muscles. Ultrassonografia Eletroneuromiografia Fasciculação Esclerose lateral amiotróficaįasciculations are rapid, random, fine, flickering, or vermicular twitching movements of a group of muscle fibers innervated by a single motor unit ( 1 1 Harding PJ, Loram ID, Combes N, et al. A ultrassonografia apresentou taxas de detecção superiores à eletroneuromiografia, independentemente do tempo de sua avaliação e dos músculos avaliados. Já na ultrassonografia de 30 s, a acurácia nos pacientes foi de 82%. A acurácia da ultrassonografia de 10 s nos músculos foi de 70%, enquanto nos pacientes foi de 85%. A avaliação da taxa de detecção por pacientes não apresentou diferença significativa entre a ultrassonografia de 10 s e 30 s. A ultrassonografia, tanto de 10 s quanto de 30 s, apresentou taxa de detecção superior à eletroneuromiografia em todos os músculos avaliados. As ferramentas Quality Assessment of Diagnostic Accuracy Studies, versão 2, e RTI item bank foram utilizadas para avaliação da qualidade do método. Foram realizadas buscas nas bases de dados eletrônicas Cochrane Library, MEDLINE, Embase e Lilacs, para estudos que avaliam a acurácia diagnóstica e as taxas de detecção da ultrassonografia e eletroneuromiografia. O objetivo deste estudo foi determinar a acurácia diagnóstica da ultrassonografia e da eletroneuromiografia para o diagnóstico da fasciculação e comparar suas taxas de detecção. Ultrasonography Electromyography Fasciculation Amyotrophic lateral sclerosis Ultrasound provided detection rates superior to those achieved with electromyography, independent of the examination time and muscles evaluated. The accuracy of ultrasound for 30 s was 82% in patients. The accuracy of ultrasound for 10 s was 70% in muscles and 85% in patients. The overall detection rate (in patients) did not differ significantly between ultrasound for 10 s and ultrasound for 30 s. Ultrasound, for 10 s or 30 s, had a higher detection rate than did electromyography in all muscles evaluated. The Quality Assessment of Diagnostic Accuracy Studies, version 2, and RTI item bank tools were used for the evaluation of methodological quality. By searching the Cochrane Library, MEDLINE, Excerpta Medica, and Latin-American and Caribbean Health Sciences Literature databases, we identified studies evaluating the diagnostic accuracy and fasciculation detection rates of ultrasound and electromyography. These findings lend support to the EMG criteria proposed at El Escorial.The objective of this study was to determine the diagnostic accuracy of ultrasound and electromyography for the detection of fasciculation in patients with amyotrophic lateral sclerosis and to compare detection rates between the two methods. The best combination of sensitivity and specificity was achieved by requiring EMG changes in two segments with abnormalities in a single muscle in the cranial and thoracic segments, but abnormalities in two muscles in the cervical and lumbosacral regions. Using receiver operating characteristic (ROC) curve analysis to examine the effect of varying the number of abnormal segments required for the diagnosis, we found an overall accuracy of 0.90 and 0.87 if one or two abnormal segments, respectively, were required. Specificity was highest (0.92-1.0) in the cranial and thoracic segments. Based on a consecutive series of 73 patients with suspected ALS, the sensitivity of electromyography (EMG) ranged from 0.2 in the cranial segment to 0.74 in the thoracic segment. The aim of this retrospective cohort study was to examine the accuracy of the El Escorial electromyographic criteria for the diagnosis of amyotrophic lateral sclerosis (ALS).
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