Steroid myopathy emg

L'EMG est la technique la plus utilisée actuellement pour le diagnostic et le suivi des myopathies. Parmi les différents types d'anomalies retrouvées, beaucoup sont aspécifiques et peuvent être rencontrées aussi bien au cours des myopathies que des neuropathies; c'est le cas des fibrillations et ondes positives, des potentiels polyphasiques et des décharges myotoniques ou répétitives complexes. On considère en général la diminution des durées des potentiels d'unité motrice comme le paramètre ayant le meilleur rapport sensibilité/spécificité pour les myopathies en EMG conventionnel. Cependant, des altérations du même type peuvent apparaître dans le atteintes des fibres motrices terminales et de la jonction neuromusculaire. Le développement de techniques d'analyse quantitative telle que l'EMG de fibre isolée, la macro-EMG, l'EMG de balayage et l'étude turns-amplitude a ouvert de nouvelles possibilités permettant d'améliorer la sensibilité et la spécificité de l'EMG dans la détection précoce des myopathies. On soulignera dans cette revue l'importance de combiner différentes techniques d'analyse pour optimiser la fiabilité diagnostique.

Dr. Salter completed medical school and a Master of Science in Human Biodynamics at McMaster University.  She completed her specialty training in Physical Medicine and Rehabilitation at the University of Manitoba in 2012.  Dr. Salter is certified in Electrodiagnostic Medicine by the Canadian Society of Clinical Neurophysiologists.  She is an assistant professor with the University of Manitoba, Undergraduate Program Director for Physical Medicine and Rehabilitation for the University of Manitoba Medical School and Service Chief for the Acquired Brain Injury Program at Riverview Health Centre. 
 

If the neurologic examination is unrevealing, a more general physical examination, searching for extramuscular signs, is warranted ( Table 6 5 , 7 – 15 , 17 , 18 , 21 , 24 – 27 , 34 , 36 , 38 ) . Mental status testing may reveal changes suggestive of a myopathy-inducing electrolyte disorder (calcium or magnesium) or an arrest of mental development as occurs in genetic myopathies. 25 , 29 The cardiovascular assessment may elicit changes consistent with a cardiomyopathy—a nonspecific consequence of many myopathy-inducing disorders—or a pericarditis, as occurs with some of the infectious and rheumatologic causes of muscle weakness. 5 , 7 , 8 , 9 , 18 , 21 , 24 , 25 , 29 , 36 , 38

The use of certain parenteral formulations of dexamethasone, hydrocortisone, methylprednisolone, prednisolone and triamcinolone is considered by the drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. Some formulations of these drugs contain benzyl alcohol which, when used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. Continuous infusions of high dosages of medications containing benzyl alcohol may, however, cause toxicity and should be avoided if possible.

Steroid myopathy emg

steroid myopathy emg

The use of certain parenteral formulations of dexamethasone, hydrocortisone, methylprednisolone, prednisolone and triamcinolone is considered by the drug manufacturers to be contraindicated in neonates, particularly premature infants and infants of low birth weight. Some formulations of these drugs contain benzyl alcohol which, when used in bacteriostatic saline intravascular flush and endotracheal tube lavage solutions, has been associated with fatalities and severe respiratory and metabolic complications in low-birth-weight premature infants. However, many experts feel that, in the absence of benzyl alcohol-free equivalents, the amount of the preservative present in these formulations should not necessarily preclude their use if they are clearly indicated. The American Academy of Pediatrics considers benzyl alcohol in low doses (such as when used as a preservative in some medications) to be safe for newborns. Continuous infusions of high dosages of medications containing benzyl alcohol may, however, cause toxicity and should be avoided if possible.

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