PT  - JOURNAL ARTICLE
AU  - Martins, Melina Pazian
AU  - de Lima, Fabrício Diniz
AU  - Bernardes Leoni, Tauana
AU  - Martinez, Alberto R M
AU  - Nubiato Crespo, Agricio
AU  - André Teixeira Kimaid, Paulo
AU  - Nucci, Anamarli
AU  - de Carvalho, Mamede
AU  - França Jr, Marcondes C
TI  - Laryngeal electromyography in amyotrophic lateral sclerosis
AID  - 10.1136/jnnp-2020-322910
DP  - 2020 Jul 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 730--732
VI  - 91
IP  - 7
4099  - http://jnnp.bmj.com/content/91/7/730.short
4100  - http://jnnp.bmj.com/content/91/7/730.full
SO  - J Neurol Neurosurg Psychiatry2020 Jul 01; 91
AB  - Background Bulbar involvement is a hallmark of amyotrophic lateral sclerosis (ALS), but surprisingly very few studies have addressed the frequency, pattern and clinical relevance of laryngeal involvement in the disease.Methods Twenty-six patients with spinal-onset ALS underwent nasofibroscopy (NF), followed by laryngeal electromyography (LEMG). We also studied resting activity and motor unit potentials of the genioglossus and masseter muscles.Results Twenty-four patients presented neurogenic changes in at least one laryngeal muscle. There were fibrillation and/or fasciculation potentials associated with chronic neurogenic changes in the same muscle in 16 patients; of these, 9 had no alteration in the genioglossus. We found no patient with tongue neurogenic changes and normal LEMG. NF was abnormal in 14 patients; in the remaining 12, LEMG identified neurogenic changes in 11 of them.Conclusion LEMG is able to identify laryngeal denervation in patients with ALS, sometimes before clinical manifestations are noticed. This technique may be a useful diagnostic tool for selected patients with suspicion of ALS.