Muscle & nerve
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Clinical Trial
Botulinum toxin improves sialorrhea and quality of living in bulbar amyotrophic lateral sclerosis.
Sialorrhea is frequently a socially disabling symptom in patients with bulbar amyotrophic lateral sclerosis (ALS). In this open-label prospective study, we report the effect of botulinum toxin A (Botox) injection into the parotid glands in 10 patients with bulbar ALS and socially disabling sialorrhea. We applied three different outcome measures to determine the effect of Botox therapy on sialorrhea. ⋯ The beneficial effect of Botox lasted for at least 2 months in those who responded. No major adverse effects were noted. Local injection of a small dose of Botox into the parotid glands can control sialorrhea and potentially improve living quality in some patients with bulbar ALS.
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Low back pain and lumbar radiculopathy are among the most common painful disorders affecting the adult population. This study hypothesizes that there is good correlation between the diagnostic impression of an unblinded electromyographer, using clinical and electromyographic information, and an independent electromyographer, who uses the needle examination only to assess for lumbar radiculopathy. This is a prospective, single-blinded, observational pilot study. ⋯ Overall diagnostic agreement was 46.9% (60.5% faculty level, 28.5% resident level). Logistic regression shows a strong association between training level and agreement on diagnostic impression (odds ratio, 1.9; 95% confidence interval, 1.12-3.22; P = 0.019). This study shows that there is fair interrater reliability between faculty-level examiners and poor reliability among resident-level examiners when the needle examination is used to evaluate patients with lumbar radiculopathy.