Die Klinische Elektromyographie in Der Differentialdiagnose Von Neuro- Und Myopathien: Eine Bilanz
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Elektromyographie, Muskelbiopsie und Enzymstudien haben die Kennt- nisse uber Krankheiten, welche mit Muskelschwund und/oder Muskelschwache einhergehen, in einem ungeahnten MaBe erweitert. Die Kranken konnen besser analysiert werden, Konduktoren lassen sich erfassen. Der Klinik wurden zahl- reiche neue Probleme aufgegeben. Das EMG wurde zum unentbehrlichen HiIfsmittel des Klinikers, besonders bei der Analyse der strukturellen - neurogenen oder myogenen - Myo- pathien; die Bedeutung fur die Erforschung der funktionellen Myopathien ist auch nicht gering. Das EMG laBt sich nur in einem beschcankten Umfang maschinell aus- werten. DieVerantwortung des untersuchendenArztesistgroB. Was BUCHTHAL deutlich ausgesprochen hat, wird jeder bald bemerken, daB man namlich auch aus gesunden Muskeln Registrierungen erhalten und abbiIden kann, die als Zeichen fUr bestimmte pathologische Veranderungen ausgegeben werden konn- ten. Deswegen hielt ich es fur ratsam, daB einer meiner klinisch besonders er- fahrenen Mitarbeiter sich der Muhe unterzog, die Methode beherrschen zu lernen und andere anzuleiten, damit nach einem gewissen Zeitraum berichtet werden konnte, welche Moglichkeiten und Grenzen der klinischen Elektromyo- graphie von uns erfahren worden sind. Die Studie stutzt sich auf mehr als 3000 elektromyographische Einzelunter- suchungen bei etwa 1200 Patienten mit chronischen neuromuskularen Prozessen und Myopathien in einem Zeitabschnitt von 5 Jahren; aus der Literatur ist bis- her kein annahernd gleichwertiges Kollektiv einheitlich untersuchter Patienten mit myositischen Myopathien bekannt. Bei der Bedeutung der klinischen EMG hat sich die Frequenz des Labora- toriums zunehmend gesteigert, mehrere Arzte mussen die Untersuchungstechnik beherrschen.
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