Article

OBJECTIVE: To characterize electromyographic abnormalities according to symptoms
(asymptomatic, fatigue, pseudobotulism) reported 1 month after botulinum toxin
injection. DESIGN: Retrospective, single-center study comparing single-fiber
electromyography (SFEMG) in the extensor digitorum communis (EDC) or orbicularis
oculi (OO) muscles. SETTING: Hospital. PARTICIPANTS: Four groups of adults
treated for spasticity or neurologic bladder hyperactivity (N=55): control group
(asymptomatic patients: n=17), fatigue group (unusual fatigue with no weakness:
n=15), pseudobotulism group (muscle weakness and/or visual disturbance: n=20),
and botulism group (from intensive care unit of the same hospital: n=3).
INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Mean jitter, percentage of
pathologic fibers, and percentage of blocked fibers were compared between groups.
RESULTS: SFEMG was abnormal for 17.6% of control patients and 75% of patients in
the pseudobotulism group. There were no differences between the control and
fatigue groups. Mean jitter, percentage of pathologic fibers, and percentage of
blocked fibers of the EDC muscle were significantly higher in the pseudobotulism
group than in the fatigue and control groups. There were no differences between
groups for the OO muscle. The SFEMG results in the botulism group were
qualitatively similar to those of the pseudobotulism group. CONCLUSIONS: SFEMG of
the EDC muscle confirmed diffusion of the toxin into muscles distant from the
injection site in the pseudobotulism group. SFEMG in the OO muscle is not useful
for the diagnosis of diffusion. No major signs of diffusion of botulinum toxin
type A were found away from the injection site in patients with fatigue but no
motor weakness. Such fatigue may be related to other mechanisms.
CI - Copyright (c) 2015 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS