The utility of EMG interference pattern analysis in botulinum toxin treatment of torticollis: a randomised, controlled and blinded study
| Autor: | Merete Karlsborg, Anders Fuglsang-Frederiksen, O. Munck, Kristian Winge, Lene Werdelin, L. Korbo, Torben Dalager, Lisbeth Regeur |
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| Rok vydání: | 2010 |
| Předmět: |
Adult
Male medicine.medical_specialty Electromyography Injections Intramuscular Physical medicine and rehabilitation Neck Muscles Physiology (medical) medicine Humans Single-Blind Method Prospective Studies Botulinum Toxins Type A Prospective cohort study Torticollis Aged Dystonia medicine.diagnostic_test business.industry Middle Aged medicine.disease musculoskeletal system Evoked Potentials Motor Neck muscles Botulinum toxin Sensory Systems body regions Treatment Outcome Neurology Neuromuscular Agents EMG interference pattern Female Neurology (clinical) business medicine.drug Blinded study |
| Zdroj: | Werdelin, L, Dalager, T, Fuglsang-Frederiksen, A, Regeur, L, Karlsborg, M, Korbo, L, Munck, O & Winge, K 2011, ' The utility of EMG interference pattern analysis in botulinum toxin treatment of torticollis: a randomised, controlled and blinded study ', Clinical Neurophysiology, vol. 122, no. 11, pp. 2305-9 . https://doi.org/10.1016/j.clinph.2011.04.012 |
| ISSN: | 1872-8952 |
| Popis: | Objective The significance of electromyography (EMG) guidance in botulinum toxin (BT) treatment has been much debated. The aim of this study was to evaluate if EMG guidance in the treatment of torticollis in BT-naive patients had a better outcome than treatment after clinical evaluation alone. Methods Twenty-six patients with torticollis were included and treated for 1year in this prospective, blinded study. Quantitative EMG was performed simultaneously in the four most frequently affected muscles: the sternocleidomastoid muscles and the posterior neck muscles on both sides. EMGs were analysed for turns per second. Clinical ratings were performed by an experienced neurologist (A). Injections were given by another neurologist (B), who was blinded to the ratings. In group 1, the results of the EMG were available to the treating neurologist B, whereas in group 2, neurologist B was blinded. In group 1, treatment with BT was given when turns per second were higher than 100. Results In patients treated guided by EMG, clinical outcome, evaluated by objective ratings, was better than in patients treated based on clinical judgement alone ( p =0.05). In group 2, 105 muscles were treated with BT. Of these, 37 did not show dystonic EMG activity. Conclusions Treatment with BT guided by EMG results in better clinical outcome than treatment without EMG and reduces the amount of BT used. Significance EMG guidance by interference pattern analysis may optimise BT treatment in torticollis by a more precise injection and may reduce side effects and the risk of development of antibodies to BT. |
| Databáze: | OpenAIRE |
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