ABSTRACT OBJECTIVE: The stimulation of the masseteric nerve elicits a homonymous and a heteronymous H reflex in the masseter muscle and in the temporalis one. The presence of the H reflex may be considered a sign of UMN involvement in ALS patients. The aim of this study was to evaluate the presence of the heteronymous H reflex in patients with ALS and compare it with normal subjects. METHODS: We enrolled 36 ALS patients and 52 healthy subjects. We stimulated the masseteric nerve in the infratemporal fossa and recorded the muscle responses ipsilaterally to the stimulation. RESULTS: The heteronymous temporalis H reflex was elicitable in 88.9% of ALS patients and in none of the controls. CONCLUSION: The heteronymous H reflex does not disappear when the stimulation intensity is increased. It can be used as sign of UMN involvement and may prove useful in patients with suspected MND/ASL with purely LMN signs and no signs of UMN involvement. SIGNIFICANCE: The heteronymous H reflex is present far more often in ALS patients than in healthy people. It is a simple test that may be used to detect UMN involvement in patients in whom the only evident signs are LMN impairment, improving diagnosis of ALS.
HETERONYMOUS H REFLEX IN TEMPORAL MUSCLE AS SIGN OF HYPEREXCITABILITY IN ALS PATIENTS / Libonati, Laura; Francesco Barone, Tommaso; Ceccanti, Marco; Cambieri, Chiara; Tartaglia, Giorgio; Onesti, Emanuela; Petrucci, Antonio; Frasca, Vittorio; Inghilleri, Maurizio. - In: CLINICAL NEUROPHYSIOLOGY. - ISSN 1388-2457. - 130:8(2019), pp. 1455-1459. [10.1016/j.clinph.2019.05.010]
HETERONYMOUS H REFLEX IN TEMPORAL MUSCLE AS SIGN OF HYPEREXCITABILITY IN ALS PATIENTS
Laura LibonatiPrimo
Writing – Original Draft Preparation
;Marco CeccantiMethodology
;Chiara CambieriInvestigation
;Giorgio TartagliaInvestigation
;Emanuela OnestiMethodology
;Antonio PetrucciInvestigation
;Vittorio FrascaPenultimo
Methodology
;Maurizio Inghilleri
Ultimo
Writing – Review & Editing
2019
Abstract
ABSTRACT OBJECTIVE: The stimulation of the masseteric nerve elicits a homonymous and a heteronymous H reflex in the masseter muscle and in the temporalis one. The presence of the H reflex may be considered a sign of UMN involvement in ALS patients. The aim of this study was to evaluate the presence of the heteronymous H reflex in patients with ALS and compare it with normal subjects. METHODS: We enrolled 36 ALS patients and 52 healthy subjects. We stimulated the masseteric nerve in the infratemporal fossa and recorded the muscle responses ipsilaterally to the stimulation. RESULTS: The heteronymous temporalis H reflex was elicitable in 88.9% of ALS patients and in none of the controls. CONCLUSION: The heteronymous H reflex does not disappear when the stimulation intensity is increased. It can be used as sign of UMN involvement and may prove useful in patients with suspected MND/ASL with purely LMN signs and no signs of UMN involvement. SIGNIFICANCE: The heteronymous H reflex is present far more often in ALS patients than in healthy people. It is a simple test that may be used to detect UMN involvement in patients in whom the only evident signs are LMN impairment, improving diagnosis of ALS.File | Dimensione | Formato | |
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