Analysis of combined tests of thoracic paraspinal muscles and sternocleidomastoid muscles and tongue muscles with electromyography for patients suffering ALS

Objective: To evaluate combined tests of thoracic paraspinal muscles and sternocleidomastoid muscle and tongue muscles with electromyography as diagnostic aids in amyotrophic lateral sclerosis (ALS). Methods: Thoracic paraspinal muscles, sternocleidomastoid muscles, tongue muscles and three-limb muscles were analysed with electromyography in 30 patients who had been identified as having ALS. Age and sex matched. 30 normal subjects were also detected in thoracic paraspinal muscles and sternocleidomastoid muscle for finding fib and psw [fibrillation potentials (fib) and positive sharp waves (psw)] serving as controls. Results: In ALS group, fib and psw were found in thoracic paraspinal muscles in 28 of 30 ALS patients (93%), abnormal in sternocleidomastoid muscle in 27 of 30 ALS patients (90%), characterized by having long-duration and high-amplitude. Fib and psw were found in tongue muscles in 12 of 30 ALS patients (40%). Normal subjects were not found abnormal in thoracic paraspinal muscles and sternocleidomastoid muscle. Conclusions: Electromyography for thoracic paraspinal muscles and sternoeleidomastoid muscle should present the same sensitive tool for diagnosis of ALS. To ALS patients, except for the test of regular three-limb muscles, we suggest that tests of thoracic paraspinal muscles and sternocleidomastoid muscle be added with electromyography so as to raise the positive rate and accuracy in early ALS diagnosis. The positive rate of tongue muscles with electromyography is lower than that of thoracic paraspinal muscles and sternocleidomastoid muscles. Because of probably causing bleeding and pain which patients cannot easily accept, the test of tongue muscles shouldn′t be used as a means of regular test.