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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1997 Dec;63(6):776–779. doi: 10.1136/jnnp.63.6.776

The role of quantitative electromyography in inclusion body myositis

T Brannagan 1, A Hays 1, D Lange 1, W Trojaborg 1
PMCID: PMC2169851  PMID: 9416815

Abstract

OBJECTIVE AND METHODS—Inclusion body myositis is said to have both myopathic and neurogenic features on electrophysiological tests. Twenty one studies from 20 patients with biopsy defined inclusion body myosis, 13of whom had quantitative electromyography (qEMG), were reviewed to determine if this technique added diagnostic specificity (one patient had both needle EMG and a later study with qEMG before muscle biopsy).
RESULTS—Excessive numbers of polyphasic motor unit potentials (MUPs) (>12% per muscle) were seen in 11 of the 13 patients. In 10 of 13 patients, mean MUP duration was abnormally reduced (26% to 48%). In three patients, mean MUP duration was abnormally reduced only after polyphasic MUPs were excluded. In all 13 patients, the simple MUP duration was reduced. Myopathy was unequivocally diagnosed in all 13 studies that included qEMG; of the remaining eight patients, the conclusions of the electrophysiological studies without qEMG was myopathy (one), neurogenic (four) or non-diagnostic (three).
CONCLUSIONS—There is no evidence of a neurogenic component in inclusion body myosis if qEMG is used. Quantitative EMG is often necessary to make an electrophysiological diagnosis of a myogenic disorder in patients with inclusion body myosis.



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Selected References

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  1. BUCHTHAL F., GULD C., ROSENFALCK P. Action potential parameters in normal human muscle and their dependence on physical variables. Acta Physiol Scand. 1954 Nov;32(2-3):200–218. doi: 10.1111/j.1748-1716.1954.tb01167.x. [DOI] [PubMed] [Google Scholar]
  2. BUCHTHAL F., PINELLI P. Analysis of muscle action potentials as a diagnostic aid in neuro-muscular disorders. Acta Med Scand Suppl. 1952;266:315–327. doi: 10.1111/j.0954-6820.1952.tb13380.x. [DOI] [PubMed] [Google Scholar]
  3. Barkhaus P. E., Nandedkar S. D., Sanders D. B. Quantitative EMG in inflammatory myopathy. Muscle Nerve. 1990 Mar;13(3):247–253. doi: 10.1002/mus.880130312. [DOI] [PubMed] [Google Scholar]
  4. Buchthal F. Electromyography in the evaluation of muscle diseases. Neurol Clin. 1985 Aug;3(3):573–598. [PubMed] [Google Scholar]
  5. Buchthal F., Kamieniecka Z. The diagnostic yield of quantified electromyography and quantified muscle biopsy in neuromuscular disorders. Muscle Nerve. 1982 Apr;5(4):265–280. doi: 10.1002/mus.880050403. [DOI] [PubMed] [Google Scholar]
  6. Carpenter S., Karpati G., Heller I., Eisen A. Inclusion body myositis: a distinct variety of idiopathic inflammatory myopathy. Neurology. 1978 Jan;28(1):8–17. doi: 10.1212/wnl.28.1.8. [DOI] [PubMed] [Google Scholar]
  7. Dalakas M. C. Polymyositis, dermatomyositis and inclusion-body myositis. N Engl J Med. 1991 Nov 21;325(21):1487–1498. doi: 10.1056/NEJM199111213252107. [DOI] [PubMed] [Google Scholar]
  8. Danon M. J., Reyes M. G., Perurena O. H., Masdeu J. C., Manaligod J. R. Inclusion body myositis. A corticosteroid-resistant idiopathic inflammatory myopathy. Arch Neurol. 1982 Dec;39(12):760–764. doi: 10.1001/archneur.1982.00510240022006. [DOI] [PubMed] [Google Scholar]
  9. Eisen A., Berry K., Gibson G. Inclusion body myositis (IBM): myopathy or neuropathy? Neurology. 1983 Sep;33(9):1109–1114. doi: 10.1212/wnl.33.9.1109. [DOI] [PubMed] [Google Scholar]
  10. Griggs R. C., Askanas V., DiMauro S., Engel A., Karpati G., Mendell J. R., Rowland L. P. Inclusion body myositis and myopathies. Ann Neurol. 1995 Nov;38(5):705–713. doi: 10.1002/ana.410380504. [DOI] [PubMed] [Google Scholar]
  11. Howard R. S., Murray N. M. Surface EMG in the recording of fasciculations. Muscle Nerve. 1992 Nov;15(11):1240–1245. doi: 10.1002/mus.880151104. [DOI] [PubMed] [Google Scholar]
  12. Joy J. L., Oh S. J., Baysal A. I. Electrophysiological spectrum of inclusion body myositis. Muscle Nerve. 1990 Oct;13(10):949–951. doi: 10.1002/mus.880131010. [DOI] [PubMed] [Google Scholar]
  13. Lindberg C., Oldfors A., Hedström A. Inclusion body myositis: peripheral nerve involvement. Combined morphological and electrophysiological studies on peripheral nerves. J Neurol Sci. 1990 Nov;99(2-3):327–338. doi: 10.1016/0022-510x(90)90167-l. [DOI] [PubMed] [Google Scholar]
  14. Lindberg C., Persson L. I., Björkander J., Oldfors A. Inclusion body myositis: clinical, morphological, physiological and laboratory findings in 18 cases. Acta Neurol Scand. 1994 Feb;89(2):123–131. doi: 10.1111/j.1600-0404.1994.tb01647.x. [DOI] [PubMed] [Google Scholar]
  15. Lotz B. P., Engel A. G., Nishino H., Stevens J. C., Litchy W. J. Inclusion body myositis. Observations in 40 patients. Brain. 1989 Jun;112(Pt 3):727–747. doi: 10.1093/brain/112.3.727. [DOI] [PubMed] [Google Scholar]
  16. Luciano C. A., Dalakas M. C. Inclusion body myositis: no evidence for a neurogenic component. Neurology. 1997 Jan;48(1):29–33. doi: 10.1212/wnl.48.1.29. [DOI] [PubMed] [Google Scholar]
  17. Mhiri C., Gherardi R. Inclusion body myositis in French patients. A clinicopathological evaluation. Neuropathol Appl Neurobiol. 1990 Aug;16(4):333–344. doi: 10.1111/j.1365-2990.1990.tb01267.x. [DOI] [PubMed] [Google Scholar]
  18. Streib E. W., Wilbourn A. J., Mitsumoto H. Spontaneous electrical muscle fiber activity in polymyositis and dermatomyositis. Muscle Nerve. 1979 Jan-Feb;2(1):14–18. doi: 10.1002/mus.880020103. [DOI] [PubMed] [Google Scholar]
  19. Trojaborg W. Quantitative electromyography in polymyositis: a reappraisal. Muscle Nerve. 1990 Oct;13(10):964–971. doi: 10.1002/mus.880131013. [DOI] [PubMed] [Google Scholar]
  20. Uncini A., Lange D. J., Lovelace R. E., Solomon M., Hays A. P. Long-duration polyphasic motor unit potentials in myopathies: a quantitative study with pathological correlation. Muscle Nerve. 1990 Mar;13(3):263–267. doi: 10.1002/mus.880130315. [DOI] [PubMed] [Google Scholar]

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