Electrophysiological features of Hirayama disease

Muscle Nerve. 2011 Aug;44(2):185-90. doi: 10.1002/mus.22028.

Abstract

Introduction: The purpose of this study was to compare the pattern of hand muscle involvement in Hirayama disease (HD) and amyotrophic lateral sclerosis (ALS).

Methods: We reviewed findings of upper limb nerve conduction studies of 46 HD patients and 60 ALS patients. The findings from 54 healthy subjects were used for comparison.

Results: In HD, the ulnar compound muscle action potential (CMAP) amplitude was more severely reduced than the median one, and the reverse pattern was observed in ALS. The mean ulnar/median (U/M) CMAP amplitude ratio was significantly lower in HD (0.64 ± 0.79) and abnormally higher in ALS (2.15 ± 1.77) compared with normal subjects (0.89 ± 0.23). An abnormally low U/M CMAP amplitude ratio (<0.6) was encountered in 34 patients with HD and in 1 with ALS. A U/M CMAP amplitude ratio ≥4.5 or absent median motor response was found only in ALS.

Conclusion: Our findings demonstrate different patterns of hand muscle involvement between these two diseases.

MeSH terms

  • Action Potentials / physiology
  • Adolescent
  • Adult
  • Aged
  • Amyotrophic Lateral Sclerosis / physiopathology
  • Child
  • Electric Stimulation
  • Evoked Potentials, Motor / physiology*
  • Female
  • Hand / innervation
  • Hand / physiopathology
  • Humans
  • Male
  • Median Nerve / physiopathology*
  • Middle Aged
  • Muscle, Skeletal / innervation
  • Muscle, Skeletal / physiopathology
  • Neural Conduction / physiology*
  • Retrospective Studies
  • Spinal Muscular Atrophies of Childhood / physiopathology*
  • Ulnar Nerve / physiopathology*

Supplementary concepts

  • Amyotrophy, monomelic