Клинико-электронейромиографический алгоритм топической диагностики синдрома мышечной гипотонии у детей раннего возраста

Abstract

Study Objective: To develop a clinical electroneuromyography (ENMG) protocol based on routine electromyography (EMG), standardization of needle EMG, and EMG parameters of the suprasegmental structures, for localization diagnosis of hypotonia syndrome (HS) in young children. Study Design: This was a comparative prospective study. Materials and Methods: One hundred and twenty-three patients, aged 1 month to 3 years, with HS of various origin underwent clinical examination and EMG. The following techniques were used for localization diagnosis by ENMG: surface EMG, needle EMG, measurement of nerve conduction velocity in peripheral motor and sensory nerves in the upper and lower limbs, F-wave measurement, and rhythmic stimulation. Study Results: The authors evaluated the possibility of describing suprasegmental disorders using the following parameters: F-wave monomorphism, myotatic reflex, and amplitude of voluntary muscular contractions. They proposed a clinical ENMG protocol for localization diagnosis of HS and a pediatric protocol for needle EMG; these approaches increased the rate of detecting HS up to 90-100%. They also developed a pediatric linear protocol for needle EMG to differentiate between myogenic and central HS. Conclusion: The study results demonstrated the high diagnostic value of ENMG-based differential diagnosis of HS, relying on the proposed protocols and on parameters indicating the condition of the suprasegmental structures. Keywords: neuromuscular disorders, hypotonia syndrome, electroneuromyography, diagnostic protocol, young children.