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Pattern of muscle involvement according to needle electromyography findings in clinically unaffected extremities of polio survivors with lower extremity weaknesses

Year 2019, Volume: 3 Issue: 9, 635 - 639, 01.09.2019
https://doi.org/10.28982/josam.612567

Abstract

Aim: Late neuromuscular deterioration may be seen in patients with a history of paralytic poliomyelitis. One of these problems is the development of a new weakness in clinically unaffected muscles. We aimed to determine needle electromyography (EMG) findings in these clinically unaffected limb muscles and to contribute to the physiotherapy strategies of poliomyelitis.

Methods: Patients with sequelae of poliomyelitis were included in this retrospective cohort study. Needle EMG findings of the patients were reviewed. If there were neurogenic needle EMG findings in the limb or muscle with no weakness, this muscle or limb was considered to be a subclinically affected muscle or limb.

Results: Eighteen patients were included in the study. Needle EMG findings of 190 muscles were analyzed. In the lower extremities, 18 (72%) of 25 clinically unaffected muscles had neurogenic needle EMG findings, and 14 (35%) of 40 upper extremity muscles had subclinical involvement. In the lower extremity muscles, this subclinical involvement was significantly higher than in the upper extremity muscles (P=0.004). In clinically unaffected upper and lower extremity muscles, the most prominent neurogenic needle EMG findings were in the deltoideus and vastus lateralis muscles, respectively (P=0.022 and P=0.028, respectively).

Conclusion: Subclinical involvement was more prominent in the lower extremity than in the upper extremity in polio survivors with weakness of lower extremity. The most prominent subclinical muscle involvement in the lower and upper extremities was the vastus lateralis and deltoideus muscles, respectively. We think that physical therapy strategies considering these findings will be beneficial for polio survivors.

Supporting Institution

The authors declared that this study has received no financial support.

References

  • 1. Agre JC, Rodriquez AA, Tafel JS. Late effects of polio: critical review of the literature on neuromuscular function. Arch Phys Med Rehabil. 1991;72:923-31.
  • 2. Horstmann DM. Epidemiology of poliomyelitis and allied diseases – 1963. Yale J Biol Med. 1963;36:5-26.
  • 3. Bodian D, Howe HA. The pathology of early arrested and nonparalytic poliomyelitis. Bull Johns Hopkins Hosp. 1941;69:135-47.
  • 4. Luciano CA, Sivakumar K, Spector SA, Dalakas MC. Electrophysiologic and histologic studies in clinically unaffected muscles of patients with prior paralytic poliomyelitis. Muscle Nerve. 1996;19(11):1413-20.
  • 5. McComas AJ, Quartly C, Griggs RC. Early and late losses of motor units after poliomyelitis. Brain. 1997;120:1415-21.
  • 6. Bodian D. Histopathological basis of clinical findings in poliomyelitis. Am J Med. 1949;6:563-78.
  • 7. Kidd D, Williams AJ, Howard RS. Poliomyelitis. Postgrad Med J. 1996;72(853):641-7
  • 8. Lo JK, Robinson LR. Postpolio syndrome and late effects of poliomyelitis. Part 1. Pathogenesis, biomechanical considerations, diagnosis, and investigations. Muscle Nerve. 2018;58(6):751-9.
  • 9. Stalberg E, Grimby G. Dynamic electromyography and muscle biopsy changes in a 4-year follow-up: study of patients with a history of polio. Muscle Nerve. 1981;4:524-8.
  • 10. Kumar K, Kapahtia NK. The pattern of muscle involvement in poliomyelitis of upper limb. Int Orthop. 1986;10(1):11-5.
  • 11. Sharrard WJ. The distribution of the permanent paralysis in the lower limb in poliomyelitis; a clinical and pathological study. J Bone Joint Surg Br. 1955;37(4):540-58.
  • 12. Farbu E, Gilhus NE, Barnes MP, Borg K, Visser M, Driessen A, et al. EFNS guideline on diagnosis and management of post-polio syndrome. Report of an EFNS task force. European Journal of Neurology. 2006;13:795-801.
  • 13. Chen S, Andary M, Buschbacher R, Del Toro D, Smith B, So Y, et al. Electrodiagnostic reference values for upper and lower limb nerve conduction studies in adult populations. Muscle Nerve. 2016;54(3):371-7.
  • 14. Jubelt B, Cashman NR. Neurological manifestations of the post-polio syndrome. Crit Rev Neurobiol. 1987;3:199-200.
  • 15. Ravits J, Hallett M, Baker M, Nilsson J, Dalakas MC. Clinical and electromyographic studies of postpoliomyelitis muscular atrophy. Muscle Nerve. 1990;13:667-74.
  • 16. Şenol MG, Kaplan C, Ozdağ F, Saraçoğlu M. How long denervation take in poliomyelitis? Or is it a lifetime? Neurosci Rural Pract. 2018;8(4):511-5.

Alt ekstremite güçsüzlüğü olan polio hastalarının klinik olarak etkilenmeyen ekstremitelerinde iğne elektromiyografi bulgularına göre kas tutulum paterni

Year 2019, Volume: 3 Issue: 9, 635 - 639, 01.09.2019
https://doi.org/10.28982/josam.612567

Abstract

Amaç: Paralitik poliomiyelit öyküsü olan hastalarda geç dönem nöromüsküler kötüleşme görülebilir. Bu sorunlardan birisi, klinik olarak etkilenmemiş kaslarda yeni bir güçsüzlüğün gelişimidir. Bu klinik olarak etkilenmemiş ekstremite kaslarındaki iğne elektromyografi (EMG) bulgularını saptamayı ve poliomiyelitin fizik tedavi stratejilerine katkıda bulunmayı amaçladık.

Yöntemler: Poliomiyelit sekeli olan hastalar bu retrospektif kohort çalışmasına çalışmaya dahil edildi. Hastaların iğne EMG bulguları gözden geçirildi. Güçsüzlüğü olmayan ekstremite veya kasta nörojenik iğne EMG bulguları varsa, bu kas veya ekstremite subklinik olarak etkilenmiş olarak kabul edildi.

Bulgular: Onsekiz hasta çalışmaya dahil edildi. Yüzdoksan kasın iğne EMG bulguları analiz edildi. Alt ekstremitelerde, klinik olarak etkilenmeyen 25 kasın 18'inde (%72) nörojenik iğne EMG bulguları vardı, 40 üst ekstremite kasının 14’ünde (%35) subklinik tutulum mevcuttu. Alt ekstremite kaslarındaki bu subklinik tutulum, üst ekstremite kaslarına göre anlamlı olarak daha fazla orandaydı (P=0,004). Klinik olarak etkilenmemiş üst ve alt ekstremite kasları içinde, en belirgin nörojenik iğne EMG bulguları sırasıyla deltoid ve vastus lateralis kaslarında idi (sırasıyla; P=0,022 ve P=0,028).

Sonuç: Alt ekstremite güçsüzlüğü olan polio hastalarında subklinik tutulum alt ekstremitede üst ekstremiteden daha belirgindi. Alt ve üst ekstremitelerde en belirgin subklinik kas tutulumu sırasıyla vastus lateralis ve deltoid kaslarındaydı. Bu bulguları dikkate alan fizik tedavi stratejilerinin polio hastaları için faydalı olacağını düşünüyoruz.

References

  • 1. Agre JC, Rodriquez AA, Tafel JS. Late effects of polio: critical review of the literature on neuromuscular function. Arch Phys Med Rehabil. 1991;72:923-31.
  • 2. Horstmann DM. Epidemiology of poliomyelitis and allied diseases – 1963. Yale J Biol Med. 1963;36:5-26.
  • 3. Bodian D, Howe HA. The pathology of early arrested and nonparalytic poliomyelitis. Bull Johns Hopkins Hosp. 1941;69:135-47.
  • 4. Luciano CA, Sivakumar K, Spector SA, Dalakas MC. Electrophysiologic and histologic studies in clinically unaffected muscles of patients with prior paralytic poliomyelitis. Muscle Nerve. 1996;19(11):1413-20.
  • 5. McComas AJ, Quartly C, Griggs RC. Early and late losses of motor units after poliomyelitis. Brain. 1997;120:1415-21.
  • 6. Bodian D. Histopathological basis of clinical findings in poliomyelitis. Am J Med. 1949;6:563-78.
  • 7. Kidd D, Williams AJ, Howard RS. Poliomyelitis. Postgrad Med J. 1996;72(853):641-7
  • 8. Lo JK, Robinson LR. Postpolio syndrome and late effects of poliomyelitis. Part 1. Pathogenesis, biomechanical considerations, diagnosis, and investigations. Muscle Nerve. 2018;58(6):751-9.
  • 9. Stalberg E, Grimby G. Dynamic electromyography and muscle biopsy changes in a 4-year follow-up: study of patients with a history of polio. Muscle Nerve. 1981;4:524-8.
  • 10. Kumar K, Kapahtia NK. The pattern of muscle involvement in poliomyelitis of upper limb. Int Orthop. 1986;10(1):11-5.
  • 11. Sharrard WJ. The distribution of the permanent paralysis in the lower limb in poliomyelitis; a clinical and pathological study. J Bone Joint Surg Br. 1955;37(4):540-58.
  • 12. Farbu E, Gilhus NE, Barnes MP, Borg K, Visser M, Driessen A, et al. EFNS guideline on diagnosis and management of post-polio syndrome. Report of an EFNS task force. European Journal of Neurology. 2006;13:795-801.
  • 13. Chen S, Andary M, Buschbacher R, Del Toro D, Smith B, So Y, et al. Electrodiagnostic reference values for upper and lower limb nerve conduction studies in adult populations. Muscle Nerve. 2016;54(3):371-7.
  • 14. Jubelt B, Cashman NR. Neurological manifestations of the post-polio syndrome. Crit Rev Neurobiol. 1987;3:199-200.
  • 15. Ravits J, Hallett M, Baker M, Nilsson J, Dalakas MC. Clinical and electromyographic studies of postpoliomyelitis muscular atrophy. Muscle Nerve. 1990;13:667-74.
  • 16. Şenol MG, Kaplan C, Ozdağ F, Saraçoğlu M. How long denervation take in poliomyelitis? Or is it a lifetime? Neurosci Rural Pract. 2018;8(4):511-5.
There are 16 citations in total.

Details

Primary Language English
Subjects Neurology and Neuromuscular Diseases
Journal Section Research article
Authors

Halit Fidancı 0000-0001-6573-9090

İlker Öztürk 0000-0002-2333-9360

Ahmet Candan Köylüoğlu This is me 0000-0002-0795-0610

Şencan Buturak This is me 0000-0002-7496-5628

Zülfikar Arlıer 0000-0003-2645-648X

Publication Date September 1, 2019
Published in Issue Year 2019 Volume: 3 Issue: 9

Cite

APA Fidancı, H., Öztürk, İ., Köylüoğlu, A. C., Buturak, Ş., et al. (2019). Pattern of muscle involvement according to needle electromyography findings in clinically unaffected extremities of polio survivors with lower extremity weaknesses. Journal of Surgery and Medicine, 3(9), 635-639. https://doi.org/10.28982/josam.612567
AMA Fidancı H, Öztürk İ, Köylüoğlu AC, Buturak Ş, Arlıer Z. Pattern of muscle involvement according to needle electromyography findings in clinically unaffected extremities of polio survivors with lower extremity weaknesses. J Surg Med. September 2019;3(9):635-639. doi:10.28982/josam.612567
Chicago Fidancı, Halit, İlker Öztürk, Ahmet Candan Köylüoğlu, Şencan Buturak, and Zülfikar Arlıer. “Pattern of Muscle Involvement According to Needle Electromyography Findings in Clinically Unaffected Extremities of Polio Survivors With Lower Extremity Weaknesses”. Journal of Surgery and Medicine 3, no. 9 (September 2019): 635-39. https://doi.org/10.28982/josam.612567.
EndNote Fidancı H, Öztürk İ, Köylüoğlu AC, Buturak Ş, Arlıer Z (September 1, 2019) Pattern of muscle involvement according to needle electromyography findings in clinically unaffected extremities of polio survivors with lower extremity weaknesses. Journal of Surgery and Medicine 3 9 635–639.
IEEE H. Fidancı, İ. Öztürk, A. C. Köylüoğlu, Ş. Buturak, and Z. Arlıer, “Pattern of muscle involvement according to needle electromyography findings in clinically unaffected extremities of polio survivors with lower extremity weaknesses”, J Surg Med, vol. 3, no. 9, pp. 635–639, 2019, doi: 10.28982/josam.612567.
ISNAD Fidancı, Halit et al. “Pattern of Muscle Involvement According to Needle Electromyography Findings in Clinically Unaffected Extremities of Polio Survivors With Lower Extremity Weaknesses”. Journal of Surgery and Medicine 3/9 (September 2019), 635-639. https://doi.org/10.28982/josam.612567.
JAMA Fidancı H, Öztürk İ, Köylüoğlu AC, Buturak Ş, Arlıer Z. Pattern of muscle involvement according to needle electromyography findings in clinically unaffected extremities of polio survivors with lower extremity weaknesses. J Surg Med. 2019;3:635–639.
MLA Fidancı, Halit et al. “Pattern of Muscle Involvement According to Needle Electromyography Findings in Clinically Unaffected Extremities of Polio Survivors With Lower Extremity Weaknesses”. Journal of Surgery and Medicine, vol. 3, no. 9, 2019, pp. 635-9, doi:10.28982/josam.612567.
Vancouver Fidancı H, Öztürk İ, Köylüoğlu AC, Buturak Ş, Arlıer Z. Pattern of muscle involvement according to needle electromyography findings in clinically unaffected extremities of polio survivors with lower extremity weaknesses. J Surg Med. 2019;3(9):635-9.