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Vojnosanitetski pregled
2018, vol. 75, br. 5, str. 439-446
jezik rada: engleski
vrsta rada: izvorni naučni članak
doi:10.2298/VSP160115330D

Creative Commons License 4.0
Poređenje dijagnostičkih kriterijuma kod bolesnika sa amiotrofičnom lateralnom sklerozom - doprinos elektromiografskih nalaza
aUniversity of Banja Luka, University Clinical Centre of the Republic of Srpska, School of Medicine, Banja Luka, Republic of Srpska, Bosnia and Herzegovina
bUniverzitet u Beogradu
cUniversity of Defence, Faculty of Medicine of the Military Medical Academy, Belgrade + Military Medical Academy, Clinic of Neurology, Belgrade

e-adresa: tihoilic@gmail.com

Projekat

Ćelijska i molekulska osnova neuroinflamacije: potencijala ciljna mesta za translacionu medicinu i terapiju (MPNTR - 41014)
Ministry of Defense of the Republic of Serbia (Project MFVMA/12/13-15)
Neinvazivna modulacija kortikalne ekscitabilnosti i plasticiteta – Razvoj metoda neinvazivne neuromodulacije centralnog nervnog sistema u ispitivanja fizioloških mehanizama, dijagnostici i terapiji (MPNTR - 175012)
Ministry of Defense of the Republic of Serbia, no. MFVMA/12/13-15

Sažetak

Dijagnoza amiotrofične lateralne skleroze (LS) zasniva se na kombinaciji kliničkih znakova i elektrofizioloških korelata patološkog procesa koji se odvija u osnovi. Novi elektrofiziološki kriterijumi, Awaji-Shima (AS), dodatno kvalifikuju kompleksne fascikulacije i neurogeno izmenjene potencijale motornih jedinica kao znakove aktivnih lezija perifernog motornog neurona, nasuprot ranije važećim revidiranim El Escorial kriterijumima (rEE). Cilj ovog istraživanja bio je da se utvrdi klinički značaj i prednosti primene AS kriterijuma, kod obolelih od ALS. Metode. 30 bolesnika (59,2 ± 10,9 godina, od kojih 57% sa spinalnom formom bolesti) sa klinički suspektnom ALS, praćeno je od vremena postavljanja dijagnoze do postizanja kategorije definitivne dijagnoze ili smrtnog ishoda. Kod bolesnika su obavljane klinička evaluacija i elektromiografski (EMG) pregledi u tromesečnim intervalima. Rezultati. Primjenom AS kriterijuma, nakon 6 meseci praćenja, kategorija verovatne ili pouzdane dijagnoze postignuta je kod svih bolesnika sa ALS, izuzev jednog (96,6%), nasuprot rEE kriterijuma (33.3%). EMG nalazi bili su pozitivni u ≥ 2 telesna regiona kod 80% bolesnika primenom AS, odnosno 67% primenom rEE. Kompleksne fascikulacije zabeležene su posebno učestalo u malim mišićima stopala (37-40%). Zaključak. Primenom AS kriterijuma kategorija vjerovatne ili pouzdane dijagnoze ALS postiže se za 2,7 meseca ranije, u poređenju sa rEE, na šta posebno utiče veća učestalost pozitivnih EMG nalaza. Ranije utvrđivanje dijagnoze donosi perspektivu veće zastupljenosti obolelih u farmakoterapijskim studijama sa novim terapeutskim agensima.

Ključne reči

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