Cuantificación de anormalidades electromiográficas en pacientes con esclerosis lateral amiotrófica
Autor: Torres Cuenca, Thomas Franklin
Asesor: Ortiz Corredor, Fernando
Fecha: 2020-12-10
Programa: Bogotá - Medicina - Especialidad en Medicina Física y Rehabilitación
Facultad: Facultad de Medicina

Resumen: Introduction: EMG abnormalities contributes to ALS diagnosis, the Awaji and El Escorial criteria establish levels of diagnosis certainty according to the findings. Sometimes it is not possible to complete the abnormalities requirements, which do not change diagnosis certainty; the quantification and scoring of EMG abnormalities could be useful as complementary measurement.
Objective : To develop a quantification score for EMG abnormalities in ALS patients which correlates with clinical and functional variables.
Methods: We include 281 patients with ALS diagnosis (possible 26%, probable 28,5%, and definitive 45.6% according Awaji criteria) with EMG evaluation of 1st dorsal interosseous, biceps braquialis, vastus medialis and tibialis anterior scoring them according active denervation and chronic reinnervation findings (range: denervation-reinnervation in 2 muscles, maximum hemibody score= 8), if don’t met two findings we study a replacement muscle (extensor indicis propius, deltoid, adductor longus and gastrocnemius respectively); we correlate the score obtained with Awaji diagnosis certainty, manual muscle testing (MRC) and ALS Functional rating scale revised  ALSFRS-R (total, gross and fine motor domains).
Results: We found a statistical significative relation into EMG scoring proposed and ALSFRS-R (r= 0,18; p=0,002), EMG scoring proposed of cervical segment and ALSFRS-R fine motor domain (r=0,30 ; p= 0,000), EMG scoring proposed of lumbar segment and ALSFRS-R gross motor domain (r=0,27 ; p= 0,000) and EMG scoring proposed and lower limb MRC (r=0,17; p=0,003.
Summary/Conclusion: Quantification and scoring of EMG abnormalities in ALS result useful as complementary measure in description and classification of lower motor neuron, correlating with clinical and functional variables.