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Yıl:2016; Cilt: 53; Sayı: 2>> Özet
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Nöropsikiyatri Arşivi; 2016;53(2):126-129
Sağlıklı Olgularda Perioküler Kaslarda İstemli Kası Sırasında Konvansiyonel (37 mm) Konsantrik İğne ile Jitter Değerleri
LB Kıraç, EK Orhan, S Gönderten, MB Baslo, AE Öge
İstanbul Üniversitesi, İstanbul
Amaç: Bu çalışmanın amacı sağlıklı olgularda istemli kası sırasında perioküler kaslarda tek kullanımlık 37 mm konsantrik iğne elektrodu ve 2 kHz alt frekans filtreleme ile kaydedilen tek lif benzeri potansiyel çiftlerinin jitter değerlerini yeniden değerlendirmektir. Yöntem: Çalışmada 129 olgunun (85 kadın, 44 erkek; yaş ortalaması 43,8±15,3 yıl) kayıtları gözden geçirildi. M. Frontalis grubunda 116 olgu, M. Orbikularis okuli grubunda 18 olgu vardı. Jitter değerleri 20 farklı çiftin ardışık farklarının ortalaması (mean consecutive difference, MCD) olarak ifade edildi. Bulgular: Ortalama MCD (n=2680) 22,5±9,7 µs (dağılım 5-121 us) idi. Üst %95’lik güvenlik sınırı 39 µs idi. Her olgu için 134 MCD değerinin ortalaması 22,5±3,7 µs (dağılım 15-33 µs) ve üst %95’lik güvenlik sınırı 30 µs idi. Her olgu için 20 kaydın 18. en yüksek MCD değeri 31,3±6,5 µs (18-53 µs) ve üst %95’lik güvenlik limiti 43,3 µs idi. Sonuç: Perioküler kaslarda kabul edilebilir sinyal kriterleri kullanılması durumunda 2 kHz alt frekans filtreleme ile konvansiyonel 37 mm konsantrik iğne elektrodu tek lif EMG için uygun maliyetli bir alternatif olabilir. Tek lif benzeri potansiyel çiftlerinden hesaplanan 44 µs üzerindeki jitter değerleri nöromüsküler kavşak bozukluğu olasılığı açısından uyarıcı olmalı ve daha ileri bir tanısal inceleme için bir gösterge teşkil etmelidir.
Jitter Values on Voluntary Active Periocular Muscles of Healthy Subjects with Conventional (37 mm) Concentric Needle Electrode
Introduction: The aim of this study was to re-evaluate jitter values of healthy subjects in whom pairs of single-fiber-like potentials were recorded from voluntary activated periocular muscles using a disposable 37-mm concentric needle electrode (CNE) with 2-kHz low-cut filtering. Methods: We reviewed the recordings of 129 subjects (85 women; 44 men; mean age, 43.8±15.3 years). The m. frontalis group included 116 subjects, and the m. orbicularis oculi group included 18 subjects. Jitter values were expressed as the mean consecutive difference (MCD) of 20 different pairs. Results: The mean MCD (n=2680) was 22.5±9.7 µs (range, 5–121 µs), and the upper 95% confidence limit (CL) was 39 µs. The mean of 134 MCD values for each subject was 22.5±3.7 µs (range, 15–33 µs), and the upper 95% CL was 30 µs. The outer limit of the 18th highest MCD values out of 20 recordings for each subject was 31.3±6.5 µs (range, 18–53 µs), with an upper 95% CL of 43.3 µs. Conclusion: Using a conventional 37-mm CNE with 2-kHz low-cut filtering may be a cost effective alternative to a single-fiber electrode in periocular muscles if strict criteria are used for acceptable signals. Jitter values of >44 µs that were calculated from single-fiber-like action potential pairs should alert the physician regarding the possibility of neuromuscular junction disorders and constitute an indication for a further diagnostic investigation

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