Concentric needle jitter on stimulated Orbicularis Oculi in 50 healthy subjects

OBJECTIVES The aim of this study was to estimate the jitter parameters in healthy controls in stimulated Orbicularis Oculi (OOc) muscle using concentric needle electrode (CNE). METHODS Fifty healthy subjects, 13 males and 37 females (21-56 years, mean age of 38±9.2 years) were studied. The zygomatic branch of facial nerve was stimulated with a bar electrode. Jitter was expressed as the mean consecutive difference (MCD). Filter settings 1000 Hz-10 kHz. RESULTS The mean MCD from individual studies (n=50, Gaussian distribution) was 21.5±1.99 μs (median=21 μs), ranging from 17.8 to 26 μs (upper limit, 97.5%, 25.5 μs). The mean and median MCD from all potentials (n=1500, non-Gaussian distribution) were 21.6 and 21 μs, ranging from 7.1 to 39 μs (upper limit, 97.5%, 33.4 μs). CONCLUSIONS Suggested practical limits in the OOc for mean MCD was 26 μs and for outliers 34 μs. SIGNIFICANCE Stimulation jitter recordings with CNE could be used in practice but borderline findings should be judged with great caution until larger database obtained with uniform setting available.

[1]  Vera Bril.  Single Fiber Electromyography , 1995, Neurology.

[2]  François Mauguière,et al.  Clinical Neurophysiology of disorders of muscle and neuromuscular junction, including fatigue. , 2003 .

[3]  E. Stålberg,et al.  Reference jitter values for concentric needle electrodes in voluntarily activated extensor digitorum communis and orbicularis oculi muscles , 2008, Muscle & nerve.

[4]  E. Stålberg,et al.  Concentric needle single fiber electromyography: Comparative jitter on voluntary-activated and stimulated Extensor Digitorum Communis , 2008, Clinical Neurophysiology.

[5]  E. Stålberg,et al.  Jitter measurement by axonal micro-stimulation. Guidelines and technical notes. , 1992, Electroencephalography and clinical neurophysiology.

[6]  D B Sanders,et al.  AAEM minimonograph #25: Single‐fiber electromyography , 1996, Muscle & nerve.

[7]  J. Trontelj,et al.  The jitter in stimulated orbicularis oculi muscle: technique and normal values. , 1988, Journal of neurology, neurosurgery, and psychiatry.

[8]  E. Stålberg,et al.  Concentric needle single fiber electromyography: normative jitter values on voluntary activated Extensor Digitorum Communis. , 2007, Arquivos de neuro-psiquiatria.

[9]  M. Farrugia,et al.  Single‐fiber EMG with a concentric needle electrode: Validation in myasthenia gravis , 2006, Muscle & nerve.

[10]  James M. Gilchrist,et al.  Single fiber EMG reference values: A collaborative effort , 1992, Muscle & nerve.

[11]  M Sonoo,et al.  Assessment of variability in the shape of the motor unit action potential, the “jiggle,” at consecutive discharges , 1994, Muscle & nerve.

[12]  Y. Ozkul.  Influence of calcium channel blocker drugs in neuromuscular transmission , 2007, Clinical Neurophysiology.

[13]  D. Wiechers.  Single fiber electromyography with a standard monopolar electrode. , 1985, Archives of physical medicine and rehabilitation.

[14]  M. Benatar,et al.  Concentric‐needle single‐fiber electromyography for the diagnosis of myasthenia gravis , 2006, Muscle & nerve.

[15]  M. Povedano,et al.  Stimulated single‐fiber EMG of the frontalis and orbicularis oculi muscles in ocular myasthenia gravis , 2003, Muscle & nerve.

[16]  Wiechers Do.  Single fiber electromyography with a standard monopolar electrode. , 1985 .

[17]  I. Mackay,et al.  Effect of multiple sclerosis materials on polymorphonuclear neutrophils of mice , 1980, Acta neurologica Scandinavica.

[18]  N. Yildiz,et al.  Concentric needle electrode for neuromuscular jitter analysis , 2000, Muscle & nerve.

[19]  B. Uludaǧ,et al.  Surface stimulation single‐fiber electromyography , 1998 .

[20]  A. Weir,et al.  Concentric and single fiber needle electrodes yield comparable jitter results in myasthenia gravis , 2009, Muscle & nerve.

[21]  J. Ekstedt,et al.  HUMAN SINGLE MUSCLE FIBER ACTION POTENTIALS. EXTRACELLULAR RECORDING DURING VOLUNTARY AND CHEMICAL ACTIVATION. WITH SOME COMMENTS ON END-PLATE PHYSIOLOGY AND ON THE FIBER ARRANGEMENT OF THE MOTOR UNIT. , 1964, Acta physiologica Scandinavica. Supplementum.

[22]  J. Payan,et al.  The blanket principle: A technical note , 1978, Muscle & nerve.

[23]  Donald B Sanders,et al.  Jitter recordings with concentric needle electrodes , 2009, Muscle & nerve.

[24]  Robin Kennett.  Clinical neurophysiology of disorders of muscle and neuromuscular junction including fatigue, Erik Stalberg (Ed.). Elsevier (September 2003), £205.00, ISBN: 0-444-50867-8 , 2004 .

[25]  E. Stålberg,et al.  Chapter 9 Electromyographic methods , 2003 .

[26]  Ernest W. Johnson.  Single Fiber Electromyography: Studies in Healthy and Diseased Muscle , 1995 .