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Master Thesis

Intérêt diagnostique du Test Combiné du Quadriceps dans la Sclérose Latérale Amyotrophique : étude de cohorte

Abstract : Objective To evaluate whether Combined Patellar Tendon Reflex-Motor Evoked Potentials to Lower Limb (T-MEP-LL) is relevant to assess corticospinal function in amyotrophic lateral sclerosis (ALS), in a monocentric retrospective study. Methods T-MEP-LL was performed on 100 patients with motor neuron disease (MND) and 35 patients with other neurological pathologies, during routine diagnosis explorations. Clinical evaluation of the patients included neurological examination, the revised ALS Functional Rating Scale (ALSFRS-R) and Medical Research Council (MRC) score. Awaji and Gold Coast criteria were determined for each patient. Survival was calculated if death occurred. Results T-MEP-LL shows a sensitivity of 66% and a specificity of 68.6% to detect MND. T-MEP-LL was abnormal in 66% of the MND patients and 31.43% of patients with other neurological pathologies (p<0,001). Among MND patients without sign of upper motor neuron (UMN), T-MEP-LL shows a greater specificity. T-MEP-LL can help to improve diagnosis criteria. T-MEP-LL results were not correlated with ALSFRS-R and MRC 31 score but it could be a prognosis factor knowing that T-MEP-LL alteration was associated with a shorter time to death (2.03 years [1.26-4.80] vs 3.16 [2.29-4.59], p=0.04). Conclusions T-MEP-LL is an easy and painless technique applicable in daily clinical practice, and it has a good sensitivity and specificity to detect motor neurone. T-MEP-LL might be an interesting prognosis factor that needs to be confirmed by other studies.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-03426391
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Submitted on : Friday, November 12, 2021 - 11:12:46 AM
Last modification on : Saturday, November 13, 2021 - 3:49:34 AM

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Annaïck Desmaison. Intérêt diagnostique du Test Combiné du Quadriceps dans la Sclérose Latérale Amyotrophique : étude de cohorte. Médecine humaine et pathologie. 2021. ⟨dumas-03426391⟩

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