Surface electromyogram and muscle ultrasonography for detection of muscle fasciculations in pediatric peripheral neuropathy.
A 12-year-old girl presented with talipes equinus of both legs, attenuation of upper and lower limb tendon reflexes, thermal hyperalgesia, and reduction of vibratory sensation. On clinical examination, muscle twitches of fingers of both hands, as well as the abductor halluces and the dorsal interossei muscles of the right foot were observed. Nerve conduction velocity was significantly declined in the upper and lower extremities. Needle electromyography (EMG) was not performed; however, ultrasonography revealed repetitive, semi-regular muscle twitches lasting 0.2-0.4s, concomitant with muscle discharges on surface EMG in the right foot muscles. These findings were compatible with contraction fasciculation in muscles under chronic reinnervation. Nerve and muscle biopsies were suggestive of chronic motor, sensory, and autonomic neuropathy. This is the first case of pediatric peripheral neuropathy where muscle fasciculation was noninvasively identified by simultaneous surface EMG and ultrasonography.
Division of Clinical Laboratory, Tottori University Hospital, Japan. Electronic address: ooguri-jscn@umin.ac.jp.
Masayoshi
M
Oguri
Division of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University, Yonago, Japan.
Yoshiaki
Y
Saito
Division of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University, Yonago, Japan.
Tetsuya
T
Okazaki
Division of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University, Yonago, Japan.
Wataru
W
Matsumura
Division of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University, Yonago, Japan.
Koyo
K
Ohno
Division of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University, Yonago, Japan; Department of Pediatrics, Tottori Prefectural Central Hospital, Tottori, Japan.
Masami
M
Togawa
Department of Pathobiological Science and Technology, Faculty of Medicine, Tottori University, Yonago, Japan.
Chisako
C
Fukuda
Department of Pathology and Laboratory Medicine, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan.
Yuko
Y
Saito
Department of Neuromuscular Research, National Institute of Neuroscience, National Center of Neurology and Psychiatry, Tokyo, Japan.
Ichizo
I
Nishino
Division of Child Neurology, Institute of Neurological Science, Faculty of Medicine, Tottori University, Yonago, Japan.
Yoshihiro
Y
Maegaki
D002648:Child; D004576:Electromyography; D005207:Fasciculation / Q000175:diagnosis* / Q000473:pathology / Q000503:physiopathology* / Q000628:therapy; D005260:Female; D006801:Humans; D035002:Lower Extremity / Q000000981:diagnostic imaging / Q000503:physiopathology; D018482:Muscle, Skeletal / Q000000981:diagnostic imaging* / Q000473:pathology / Q000503:physiopathology*; D009431:Neural Conduction; D009468:Neuromuscular Diseases / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy; D014463:Ultrasonography; D034941:Upper Extremity / Q000000981:diagnostic imaging / Q000503:physiopathology; D014839:Vomiting / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000628:therapy
Autonomic sensory motor neuropathy; Fasciculation; Peripheral neuropathy; Surface electromyography; Ultrasonography