Bedeutung der Muskelsonographie in der Detektion von Faszikulationen bei der ALS

Zusammenfassung

Bei der amyotrophen Lateralsklerose sind Faszikulationen häufig bereits in frühen Stadien in mehreren Körperregionen vorzufinden und haben daher Eingang in die entsprechenden Leitlinien und Diagnosekriterien gefunden. Während die invasive EMG-Diagnostik unverzichtbar zum Nachweis von akut- und chronisch-neurogenen Veränderungen des elektrischen Signalverhaltens motorischer Einheiten und zur Bestätigung von Faszikulationspotenzialen bleibt, bietet die Muskelsonographie ein hochsensitives Verfahren, um schnell und nicht-invasiv Faszikulationen in den verschiedenen Muskel-Etagen zu erfassen. In dieser Übersichtsarbeit stellen wir die bisherigen Daten zum Einsatz der Muskelsonographie zur Faszikulationsdetektion dar. Durch ihren Einsatz ermöglicht die Muskelsonographie im klinischen Alltag eine zielgerichtete und hierdurch aussagekräftigere EMG-Diagnostik. Aktuelle Forschungsstudien zielen darauf ab, Faszikulationen sonomorphologisch genauer zu charakterisieren, zu quantifizieren und als Verlaufsparameter zu untersuchen.

Abstract

In amyotrophic lateral sclerosis, fasciculations are frequently present at early stages in multiple body regions which is why they were included in guidelines and diagnostic criteria. While invasive EMG recording remains indispensable for detecting acute and chronic neurogenic changes in motor unit action potentials and firing patterns as well as to confirm the presence of fasciculation potentials, muscle ultrasonography provides a highly sensitive method to rapidly and non-invasively detect fasciculations in the different body regions. In this review, we summarize current data on the use of muscle ultrasonography for the detection of fasciculations, and we describe how muscle ultrasonography allows targeted EMG diagnosis in clinical practice. Current research studies aim to analyze fasciculations more precisely regarding their quantity and morphology, as well as their potential as a progression parameter.

Schlüsselwörter

Muskelsonographie - Faszikulationen - amyotrophe Lateralsklerose

Key words

muscle ultrasonography - fasciculations - amyotrophic lateral sclerosis

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