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JMD : Journal of Movement Disorders

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Review Articles
Principles of Electrophysiological Assessments for Movement Disorders
Kai-Hsiang Stanley Chen, Robert Chen
J Mov Disord. 2020;13(1):27-38.   Published online January 31, 2020
DOI: https://doi.org/10.14802/jmd.19064
  • 9,243 View
  • 816 Download
  • 21 Citations
AbstractAbstract PDFSupplementary Material
Electrophysiological studies can provide objective and quantifiable assessments of movement disorders. They are useful in the diagnosis of hyperkinetic movement disorders, particularly tremors and myoclonus. The most commonly used measures are surface electromyography (sEMG), electroencephalography (EEG) and accelerometry. Frequency and coherence analyses of sEMG signals may reveal the nature of tremors and the source of the tremors. The effects of voluntary tapping, ballistic movements and weighting of the limbs can help to distinguish between organic and functional tremors. The presence of Bereitschafts-potentials and beta-band desynchronization recorded by EEG before movement onset provide strong evidence for functional movement disorders. EMG burst durations, distributions and muscle recruitment orders may identify and classify myoclonus to cortical, subcortical or spinal origins and help in the diagnosis of functional myoclonus. Organic and functional cervical dystonia can potentially be distinguished by EMG power spectral analysis. Several reflex circuits, such as the long latency reflex, blink reflex and startle reflex, can be elicited with different types of external stimuli and are useful in the assessment of myoclonus, excessive startle and stiff person syndrome. However, limitations of the tests should be recognized, and the results should be interpreted together with clinical observations.
Electrophysiological Evaluation of Oropharyngeal Dysphagia in Parkinson’s Disease
Cumhur Ertekin
J Mov Disord. 2014;7(2):31-56.   Published online October 30, 2014
DOI: https://doi.org/10.14802/jmd.14008
  • 26,210 View
  • 234 Download
  • 27 Citations
AbstractAbstract PDF
Parkinson’s disease (PD) is a chronic, neurodegenerative movement disorder that typically affects elderly patients. Swallowing disorders are highly prevalent in PD and can have grave consequences, including pneumonia, malnutrition, dehydration and mortality. Neurogenic dysphagia in PD can manifest with both overt clinical symptoms or silent dysphagia. Regardless, early diagnosis and objective follow- up of dysphagia in PD is crucial for timely and appropriate care for these patients. In this review, we provide a comprehensive summary of the electrophysiological methods that can be used to objectively evaluate dysphagia in PD. We discuss the electrophysiological abnormalities that can be observed in PD, their clinical correlates and the pathophysiology underlying these findings.
Original Article
Unilateral Standing Leg Tremor as the Initial Manifestation of Parkinson Disease
Suk Yun Kang, Sook-Keun Song, Jin-Soo Kim, Young Ho Sohn
J Mov Disord. 2009;2(1):29-32.
DOI: https://doi.org/10.14802/jmd.09007
  • 9,802 View
  • 86 Download
  • 1 Citations
AbstractAbstract PDF
Background:

The aim of this study was to analyze the different forms of leg tremors exhibited while standing in patients with Parkinson disease (PD), and to determine if the type of leg tremor exhibited is indicative of prognosis or treatment response in PD patients.

Methods:

We studied the clinical characteristics of five PD patients (all women; mean age, 59 years, range, 53–64 years) with unilateral standing leg tremor as the initial manifestation of PD, including their electrophysiological findings and the results of long-term follow-up.

Results:

For each patient, parkinsonism either existed at the time of onset of the initial symptoms or developed later. Patient responses to drugs were generally good, but one patient showed a poor response to drugs, even though she had only a low frequency leg tremor. For two patients whom we could observe during the 10-year follow-up period, neither the leg tremor nor parkinsonism was aggravated.

Conclusions:

There are two forms of unilateral standing leg tremor in PD. One form is high frequency, similar to the primary orthostatic tremor. The other is low frequency and similar to the parkinsonian resting tremor. Based on these observations, it appears that progression might be slow if PD patients have standing leg tremor as the initial manifestation.


JMD : Journal of Movement Disorders