Chapter

Quantitative Motor Unit Number Estimates

Jasper R. Daube

in Clinical Neurophysiology

Third edition

Published on behalf of © Mayo Foundation for Medical Education and Research

Published in print April 2009 | ISBN: 9780195385113
Published online April 2013 | e-ISBN: 9780199322770 | DOI: http://dx.doi.org/10.1093/med/9780195385113.003.0029

Series: Contemporary Neurology Series

Quantitative Motor Unit Number Estimates

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The all-or-none increment, the STA, DQEMG, MPS, and the STAT MUNE methods of obtaining MUNE give similar values in each of the muscles compared in normal subjects. Alternative MUNE methods continue to be developed, but none have been used sufficiently in a clinical setting to assess them. 64 In addition, Felice has shown that MUNE is more reliable than other measurements in documenting the course of ALS. 38 Thus each of these methods can be used whenever and wherever it is most feasible and that different methods may be appropriate in different settings. For example, when each of the motor units can be identified with small increments of stimuli in a severe neurogenic process, MUNE is defined most rapidly and accurately by actually counting the total number of increments. When the number of motor units is too large to do this or their size is too small for them to be identified accurately in the CMAP, the STAT MUNE or multipoint methods are appropriate. In muscles in which CMAPs cannot be obtained reliably, as in proximal muscles that are difficult to immobilize during stimulation of the motor nerve, the STA and DQEMG methods are most appropriate. The value of other methods of MUNE remains to be determined. 65–69

Chapter.  10089 words.  Illustrated.

Subjects: Neurology

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