Fasciculation potentials in amyotrophic lateral sclerosis and the diagnostic yield of the Awaji algorithm

Muscle Nerve. 2012 Feb;45(2):175-82. doi: 10.1002/mus.22299.

Abstract

Introduction: The role of fasciculation potentials (FPs) in the diagnosis of amyotrophic lateral sclerosis (ALS) has been underrated. The Awaji algorithm has restored the value of FPs. Our aim was to test the diagnostic yield of the Awaji algorithm, with consideration of FPs.

Methods: Subjects consisted of 139 consecutive ALS patients retrospectively enrolled over 5 years. At presentation we evaluated the diagnostic categories using the revised El Escorial Criteria (R-EEC) and the Awaji algorithm.

Results: The percentage of patients classified as confirmed ALS, clinically probable (laboratory-supported), or higher was 43% using the R-EEC and 37% using the Awaji algorithm. Thirteen patients with upper motor neuron signs only in one body region showed a decrease in their category using the Awaji algorithm. FPs were observed in 89% of ALS patients and were frequent in proximal muscles.

Conclusion: The sensitivity of the Awaji algorithm is lower than that of the R-EEC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Action Potentials / physiology*
  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms*
  • Amyotrophic Lateral Sclerosis / complications*
  • Electromyography
  • Fasciculation / diagnosis*
  • Fasciculation / etiology*
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sensitivity and Specificity