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Update on the diagnostic clinical neurophysiology for rheumatology
Affiliations- Department of Organization and Management in Health Care, Poznan University of Medical Sciences, Poland
- Department of Pathophysiology of Locomotor Organs, Poznan University of Medical Sciences, Poland
- Department and Clinic of Rheumatology, Rehabilitation and Internal Medicine, Poznan University of Medical Sciences, Poland
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Abstract
The current concepts on the clinical neurophysiology examinations for the differential diagnosis of rheumatic diseases are presented. The review aims to provide experience and practical guidelines, especially regarding electromyography. More needle than surface electromyography examinations at muscle rest or during its maximal contraction may reveal the characteristic effects of the myogenic injury caused by particular rheumatic diseases. The diagnosis of myopathic disorders, often found in rheumatic diseases is difficult because of the frequent vasculitis coexistence in the patients evoking subsequent changes in nerve fibres leading to degenerative neurogenic changes that may overlap the diagnostic picture of the primary myogenic changes caused by rheumatic diseases. In these cases, the neurophysiological studies of efferent and afferent neural transmission often reveal peripheral neuropathies just at the subclinical level.
Abstract
The current concepts on the clinical neurophysiology examinations for the differential diagnosis of rheumatic diseases are presented. The review aims to provide experience and practical guidelines, especially regarding electromyography. More needle than surface electromyography examinations at muscle rest or during its maximal contraction may reveal the characteristic effects of the myogenic injury caused by particular rheumatic diseases. The diagnosis of myopathic disorders, often found in rheumatic diseases is difficult because of the frequent vasculitis coexistence in the patients evoking subsequent changes in nerve fibres leading to degenerative neurogenic changes that may overlap the diagnostic picture of the primary myogenic changes caused by rheumatic diseases. In these cases, the neurophysiological studies of efferent and afferent neural transmission often reveal peripheral neuropathies just at the subclinical level.
Keywords
rheumatic diseases; clinical neurophysiology; electromyography; differential diagnosis
About this articleTitle
Update on the diagnostic clinical neurophysiology for rheumatology
Journal
Issue
Article type
Review paper
Pages
163-168
Published online
2022-12-29
Page views
1750
Article views/downloads
58
DOI
10.5603/RF.2022.0023
Bibliographic record
Rheumatology Forum 2022;8(4):163-168.
Keywords
rheumatic diseases
clinical neurophysiology
electromyography
differential diagnosis
Authors
Przemysław Daroszewski
Katarzyna Kaczmarek
Włodzimierz Samborski
Dorota Sikorska
Juliusz Huber
References (22)- Huber J. Diagnostyka neurofizjologiczna. In: Zimmermann-Górska I. ed. Reumatologia kliniczna. PZWL, Warszawa 2008: 247–260.
- Huber J. Badania neurofizjologiczne. In: Szczeklik A, Gajewski P. ed. Interna Szczeklika. Medycyna Praktyczna, Kraków 2022.
- Bhattacharyya S, Helfgott SM. Neurologic complications of systemic lupus erythematosus, sjögren syndrome, and rheumatoid arthritis. Semin Neurol. 2014; 34(4): 425–436.
- Graf J, Imboden J. Vasculitis and peripheral neuropathy. Curr Opin Rheumatol. 2019; 31(1): 40–45.
- Bohan A, Peter JB, Bowman RL, et al. Computer-assisted analysis of 153 patients with polymyositis and dermatomyositis. Medicine (Baltimore). 1977; 56(4): 255–286.
- Ghosh PS, Sorenson EJ. Diagnostic yield of electromyography in children with myopathic disorders. Pediatr Neurol. 2014; 51(2): 215–219.
- Wu Y, Martnez MM, Balaguer PO. Overview of the application of EMG recording in the diagnosis and approach of neurological disorders. Electrodiagnosis in New Frontiers of Clinical Research. 2013.
- Falck B, Stålberg E. Motor nerve conduction studies: measurement principles and interpretation of findings. J Clin Neurophysiol. 1995; 12(3): 254–279.
- Hellmann M, von Kleist-Retzow JC, Haupt WF, et al. Diagnostic value of electromyography in children and adolescents. J Clin Neurophysiol. 2005; 22(1): 43–48.
- Sanders DB, Stålberg E, Nandedkar S. Analysis of the electromyographic interference pattern. J Clin Neurophysiol. 1996; 13(5): 385–400.
- Stålberg E, Erdem H. Quantitative motor unit potential analysis in routine. Electromyogr Clin Neurophysiol. 2002; 42(7): 433–442.
- Thornton RC, Michell AW. Techniques and applications of EMG: measuring motor units from structure to function. J Neurol. 2012; 259(3): 585–594.
- Wytrazek M, Huber J, Lisinski P. Changes in muscle activity determine progression of clinical symptoms in patients with chronic spine-related muscle pain. A complex clinical and neurophysiological approach. Funct Neurol. 2011; 26(3): 141–149.
- Huber J, Lisiński P. Early results of supervised versus unsupervised rehabilitation of patients with cervical pain. Int J Artif Organs. 2019; 42(12): 695–703.
- Barkhaus PE, Nandedkar SD, Sanders DB. Quantitative EMG in inflammatory myopathy. Muscle Nerve. 1990; 13(3): 247–253.
- Uncini A, Lange DJ, Lovelace RE, et al. Long-duration polyphasic motor unit potentials in myopathies: a quantitative study with pathological correlation. Muscle Nerve. 1990; 13(3): 263–267.
- Marvi U, Chung L, Fiorentino DF. Clinical presentation and evaluation of dermatomyositis. Indian J Dermatol. 2012; 57(5): 375–381.
- Dalakas MC, Hohlfeld R. Polymyositis and dermatomyositis. Lancet. 2003; 362(9388): 971–982.
- Briani C, Doria A, Sarzi-Puttini P, et al. Update on idiopathic inflammatory myopathies. Autoimmunity. 2006; 39(3): 161–170.
- Blijham PJ, Hengstman GJD, Hama-Amin AD, et al. Needle electromyographic findings in 98 patients with myositis. Eur Neurol. 2006; 55(4): 183–188.
- Brannagan TH, Hays AP, Lange DJ, et al. The role of quantitative electromyography in inclusion body myositis. J Neurol Neurosurg Psychiatry. 1997; 63(6): 776–779.
- Gutiérrez-Gutiérrez G, Barbosa López C, Navacerrada F, et al. Use of electromyography in the diagnosis of inflammatory myopathies. Reumatol Clin. 2012; 8(4): 195–200.
