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Proximal-distal motor unit number estimationdynamic changes in patients with amyotrophic lateral sclerosis A one-year follow-up

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Neural Regeneration Research 2010年第8期5卷 597-601页

作者： Sartucci Ferdinando moscato gianluca Rossi Chiara Caleo Matteo Bocci Tommaso Murri Luigi Giannini Fabio Rossi Alessandro Department of Neuroscience Unit of NeurologyPisa University Medical School Institute of Neuroscience Unit of Neurophysiopathology Pontedera Hospital Pisa Department of Neurological Neurosurgical and Behavioural Sciences Siena University Medical School

BACKGROUND：Amyotrophic lateral sclerosis （ALS） is the most common of all the motor neuron diseases and the absence of a biologic marker has made both diagnosis and tracking evolution of the disease difficult, Electrodiagnostic tests play a fundamental role in quantifying pathological changes in the motor unit ***：We assessed distal-proximal Motor Unit （MU） loss and changes using the method of motor unit number estimation （MUNE）.DESIGN, TIME AND SETTING：A case-control study was performed at the Department of Neuroscience, Pisa University Medical School, Italy from December 1999 to November 2009. PARTICIPANTS：A total of 50 ALS patients were recruited, 30 males：mean age （59.6 ± 13.3） years; 20 females：mean age （63.9 ± 11.7） years; range （30-82） years; all patients had probable or definite ALS. Thirty healthy volunteers were recruited from department staffs, including 20 males and 10 females; mean age （57.7 ± 13.8） years served as ***：MUNE was performed for both the biceps brachii and abductor digiti minimi muscles of the same side. The technique used relayed substantially on manual incremental stimulation of the motor nerve, known as the McComas technique （50 ms sweep duration, a gain of 2 mV/Div for M wave, 0.5 mV/Div for each step; filters 10-20 kHz）.MAIN OUTCOME MEASURES：MUNE results were ***：Functioning MU numbers, measured by MUNE, decreased in the biceps brachii and abductor digiti minimi muscles over the entire one-year follow-up period （one assessment every three months） compared with baseline determination, the rate of MU decrease was similar in both muscles, but steeper ***：MUNE is a feasible method for ALS patients both proximally and distally to track changes over time in muscle MUs during the disease＇s evolution.

关键词： motor unit number estimation amyotrophic lateral sclerosis motor neuron disease time changes denervation reinnervation

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Steroids and plasma exchange in Isaacs' syndromewith anti-Caspr2 antibodies

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Neuroimmunology and Neuroinflammation 2018年第3期5卷 5-9页

作者： Daniele Orsucci Gianfranco Cafforio gianluca moscato Alessandro Napolitano Marco Margelli Monica Mazzoni Unit of Immunohematology and Transfusional Medicine San Luca HospitalLucca55100Italy

Isaacs' syndrome is a disease characterized by nerve hyperexcitability. The patients are commonly treated with symptomatic therapies and immunomodulatory approaches, but no clinical trials are available to date. Here, we report the case of an anti-Caspr2-positive patient, presenting with continuous muscle twitches and diffuse muscle pain. He experienced a nearly complete clinical response to intravenous high-dose steroids combined with plasma exchange, sustained for at least 1 year. Our experience suggests that methylprednisolone 1000 mg/day × 5 days and consecutive tapering followed by plasma exchange may be efficient and well tolerated in patient with Isaacs' syndrome due to anti-Caspr2 antibodies.

关键词： Contactin-associated protein-2 Isaac neuromuscular hyperexcitability neuromyotonia voltage-gated potassium channel

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