Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis

Neurophysiological testing plays a very important role in the diagnosis of amyotrophic lateral sclerosis (known in the British world as motor neuron disease). As specified in the Awaji criteria, electromyography is critical for defining the neurogenic changes due to involvement of the lower motor ne...

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Main Author: David Burke
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Neurological Sciences and Neurophysiology
Subjects:
Online Access:http://www.nsnjournal.org/article.asp?issn=2636-865X;year=2022;volume=39;issue=1;spage=1;epage=7;aulast=Burke
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author David Burke
author_facet David Burke
author_sort David Burke
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description Neurophysiological testing plays a very important role in the diagnosis of amyotrophic lateral sclerosis (known in the British world as motor neuron disease). As specified in the Awaji criteria, electromyography is critical for defining the neurogenic changes due to involvement of the lower motor neuron (LMN), and it can do so for muscles that are not involved clinically or are so only minimally. Demonstrating LMN involvement can be enhanced by the judicious use of neuromuscular ultrasound and imaging, particularly whole-body magnetic resonance imaging. There is a gap with involvement of the upper motor neuron (UMN), with promising procedures yet to be adopted widely. Reflex function can be used to demonstrate hyperreflexia and sometimes that paresis is at least partly of UMN origin. Protocols using transcranial magnetic stimulation can demonstrate enhanced excitability of interneuronal circuits in motor cortex and thereby pathology involving the UMN. The motivation behind studies using these and other techniques is to be able to make the diagnosis before the disease has spread significantly from its site of onset, when the clinical deficit is still minor.
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spelling doaj.art-8ade89c0aa7a43af8dce203bdd897ec32022-12-22T03:03:02ZengWolters Kluwer Medknow PublicationsNeurological Sciences and Neurophysiology2636-865X2022-01-013911710.4103/nsn.nsn_199_21Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosisDavid BurkeNeurophysiological testing plays a very important role in the diagnosis of amyotrophic lateral sclerosis (known in the British world as motor neuron disease). As specified in the Awaji criteria, electromyography is critical for defining the neurogenic changes due to involvement of the lower motor neuron (LMN), and it can do so for muscles that are not involved clinically or are so only minimally. Demonstrating LMN involvement can be enhanced by the judicious use of neuromuscular ultrasound and imaging, particularly whole-body magnetic resonance imaging. There is a gap with involvement of the upper motor neuron (UMN), with promising procedures yet to be adopted widely. Reflex function can be used to demonstrate hyperreflexia and sometimes that paresis is at least partly of UMN origin. Protocols using transcranial magnetic stimulation can demonstrate enhanced excitability of interneuronal circuits in motor cortex and thereby pathology involving the UMN. The motivation behind studies using these and other techniques is to be able to make the diagnosis before the disease has spread significantly from its site of onset, when the clinical deficit is still minor.http://www.nsnjournal.org/article.asp?issn=2636-865X;year=2022;volume=39;issue=1;spage=1;epage=7;aulast=Burkeamyotrophic lateral sclerosiselectromyographytranscranial magnetic stimulation
spellingShingle David Burke
Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis
Neurological Sciences and Neurophysiology
amyotrophic lateral sclerosis
electromyography
transcranial magnetic stimulation
title Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis
title_full Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis
title_fullStr Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis
title_full_unstemmed Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis
title_short Neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis
title_sort neurophysiological testing in the diagnosis of amyotrophic lateral sclerosis
topic amyotrophic lateral sclerosis
electromyography
transcranial magnetic stimulation
url http://www.nsnjournal.org/article.asp?issn=2636-865X;year=2022;volume=39;issue=1;spage=1;epage=7;aulast=Burke
work_keys_str_mv AT davidburke neurophysiologicaltestinginthediagnosisofamyotrophiclateralsclerosis