Electrophysiologic Evidence of Spinal Accessory Neuropathy in Patients With Cervical Myofascial Pain Syndrome

被引:18
作者
Chang, Chein-Wei [1 ]
Chang, Kai-Yin [2 ]
Chen, Yu-Ren [3 ]
Kuo, Po-Ling [3 ,4 ]
机构
[1] Natl Taiwan Univ, Dept Phys Med & Rehabil, Coll Med & Hosp, Taipei 100, Taiwan
[2] Natl Chiao Tung Univ, Inst Informat Management, Hsinchu, Taiwan
[3] Natl Taiwan Univ Hosp, Dept Phys Med & Rehabil, Taipei, Taiwan
[4] Natl Taiwan Univ, Dept Elect Engn, Taipei 100, Taiwan
来源
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION | 2011年 / 92卷 / 06期
关键词
Accessory nerve; Electromyography; Electrophysiology; Myofascial pain syndromes; Rehabilitation; TRIGGER POINTS; NERVE; MOTOR; DEGENERATION; POTENTIALS; MECHANISMS;
D O I
10.1016/j.apmr.2011.01.010
中图分类号
R49 [康复医学];
学科分类号
100215 ;
摘要
Chang C-W, Chang K-Y, Chen Y-R, Kuo P-L. Electrophysiologic evidence of spinal accessory neuropathy in patients with cervical myofascial pain syndrome. Arch Phys Med Rehabil 2011;92:935-40. Objective: To evaluate whether or not spinal accessory neuropathy exists in patients with cervical myofascial pain syndrome (MFPS). Design: Prospective study. Setting: A neurophysiologic laboratory in a university hospital. Participants: Patients with cervical MFPS (n=25) and healthy controls (n=20). Interventions: Not applicable. Main Outcome Measures: We performed nerve conduction studies (NCSs) in bilateral spinal accessory nerves, and electromyography and stimulated single-fiber electromyography in the trapezius muscles of all patients and controls. Parameters including nerve conduction velocities (NCVs), amplitudes and areas of compound muscle action potentials (CMAPs), and mean consecutive differences (MCDs) in single-fiber electromyography were measured, analyzed, and compared with the disease durations of the patients. Results: Spinal accessory NCSs showed normative NCVs but with prominently reduced CMAP amplitude in the patients with cervical MFPS, which is recognized as an axonal neuropathy of the spinal accessory nerves. Electromyography showed prominent evidence of denervation and reinnervation patterns in 48% of the MFPS patients. The abnormal MCDs in single-fiber electromyography indicated a synaptic delay of motor endplates in the motor units, and may signify evolving instability of neuromuscular transmission in the spinal accessory nerves innervating trapezius muscles of the patients. Conclusions: This study demonstrates electrophysiologic evidence of neuroaxonal degeneration and neuromuscular transmission disorder in a significant proportion of patients with cervical MFPS. We suggest that spinal accessory neuropathy may be associated with cervical MFPS.
引用
收藏
页码:935 / 940
页数:6
相关论文
共 29 条
[1]   Muscle pain: Sensory implications and interaction with motor control [J].
Arendt-Nielsen, Lars ;
Graven-Nielsen, Thomas .
CLINICAL JOURNAL OF PAIN, 2008, 24 (04) :291-298
[2]   Bilateral activation of motor unit potentials with unilateral needle stimulation of active myofascial trigger points [J].
Audette, JF ;
Wang, F ;
Smith, H .
AMERICAN JOURNAL OF PHYSICAL MEDICINE & REHABILITATION, 2004, 83 (05) :368-374
[3]   FIBROSITIC MYOFASCIAL PAIN IN INTERMITTENT CLAUDICATION - SIGNIFICANCE OF TRIGGER AREAS IN THE CALF [J].
BARTOLI, V ;
DORIGO, B ;
GRISILLO, D ;
BECONI, D .
ANGIOLOGY, 1980, 31 (01) :11-20
[4]   Myofascial pain [J].
Borg-Stein, J ;
Simons, DG .
ARCHIVES OF PHYSICAL MEDICINE AND REHABILITATION, 2002, 83 (03) :S40-S47
[5]   Disability and related factors in patients with chronic cervical myofascial pain [J].
Cakit, Burcu Duyur ;
Genc, Hakan ;
Altuntas, Vedat ;
Erdem, Hatice Rana .
CLINICAL RHEUMATOLOGY, 2009, 28 (06) :647-654
[6]   Evidence of neuroaxonal degeneration in myofascial pain syndrome: A study of neuromuscular jitter by axonal microstimulation [J].
Chang, Chein-Wei ;
Chen, Yu-Ren ;
Chang, Kai-Fong .
EUROPEAN JOURNAL OF PAIN, 2008, 12 (08) :1026-1030
[7]   ACCESSORY NERVE - CONDUCTION STUDIES [J].
CHERINGTON, M .
ARCHIVES OF NEUROLOGY, 1968, 18 (06) :708-+
[8]   Characteristics of electrical activity in trapezius muscles with myofascial pain [J].
Chung, Jin Woo ;
Ohrbach, Richard ;
McCall, W. D., Jr. .
CLINICAL NEUROPHYSIOLOGY, 2006, 117 (11) :2459-2466
[9]   Central mechanisms in the maintenance of chronic widespread noninflammatory muscle pain [J].
DeSantana, Josimari M. ;
Sluka, Kathleen A. .
CURRENT PAIN AND HEADACHE REPORTS, 2008, 12 (05) :338-343
[10]   Sympathetic facilitation of hyperalgesia evoked from myofascial tender and trigger points in patients with unilateral shoulder pain [J].
Ge, Hong-You ;
Fernandez-de-las-Penas, Cesar ;
Arendt-Nielsen, Lars .
CLINICAL NEUROPHYSIOLOGY, 2006, 117 (07) :1545-1550