Efficacy of transcutaneous electrical nerve stimulation in the treatment of a patient with amyotrophic lateral sclerosis due to syringomyelia

M. Al-Zamil, N. Kulikova, E. Vasilieva
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Abstract

This paper demonstrates a clinical case of the development of amyotrophic lateral sclerosis with lesions of the anterior horns of the spinal cord in the cervicothoracic region against the background of syringomyelia. The main complaints of the patient at the initial request for medical care were associated with weakness and hypotrophy of the right hand. Electrokymography revealed signs of damage to the anterior horns of the spinal cord at the C5Th1 level with a predominant lesion of the motor fibers of the right median and ulnar nerves. As a result, a diagnosis of amyotrophic lateral sclerosis was made. Magnetic resonance imaging revealed the presence of Chiari I malformation and severe syringomyelia of the cervical and thoracic calving of the spinal cord. The patient underwent surgical posterior decompression of the foramen magnum. However, the treatment was not effective with the worsening of the neurological deficit in the right hand and the spread of motor deficit and hypotrophy to the left hand. After the use of transcutaneous electrical neurostimulation of the median and ulnar nerves, there was a significant regression of motor deficit with a decrease in the severity of malnutrition without significant changes in the electromyography parameters of the median and ulnar nerves. The absence of neurological deficit in the lower extremities, with the preservation of tendon reflexes in the norm, and the absence of pathological reflexes, indicates a high plasticity of the pyramidal tracts at the level of the spinal cord. Regression of motor deficit after the use of transcutaneous electrical nerve stimulation is due to improvement in the state of altered motor units with hypertrophy of muscle fibers and acceleration of reinnervation processes.
经皮神经电刺激治疗脊髓空洞性肌萎缩侧索硬化症1例疗效观察
这篇论文展示了一个临床病例的发展肌萎缩性侧索硬化症与病变的脊髓前角在颈胸区对脊髓空洞的背景。患者最初要求就医时的主要主诉是右手无力和萎缩。心电图显示脊髓前角在C5Th1水平有损伤的迹象,主要是右正中神经和尺神经的运动纤维损伤。结果,诊断为肌萎缩性侧索硬化症。磁共振成像显示存在Chiari I畸形和严重脊髓脊髓脊髓颈和胸裂。患者接受了枕骨大孔后路减压手术。然而,随着右手神经功能缺损的加重,运动功能缺损和功能减退向左手扩散,治疗效果不佳。经皮正中、尺神经电刺激后,运动缺陷明显消退,营养不良严重程度降低,正中、尺神经肌电参数无明显变化。下肢神经功能缺损的缺失,正常肌腱反射的保留,以及病理性反射的缺失,表明脊髓水平锥体束具有高度可塑性。经皮神经电刺激后运动缺陷的消退是由于运动单元改变状态的改善,肌肉纤维肥大,神经再支配过程加速。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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