Diagnostic and Prognostic Value of External Anal SphincterEMGPatterns in Multiple System Atrophy

Abstract

Background It is debated whether external anal sphincter (EAS) electromyography can distinguish between multiple system atrophy (MSA) and Parkinson's disease (PD), whereas its usefulness for MSA prognosis is unknown. Objectives We explored the diagnostic and prognostic value and clinical correlations of EAS electromyography patterns in MSA. Methods We collected clinical data and EAS electromyography findings in 72 patients with MSA and 21 with PD. Results We identified four EAS patterns. The normal pattern was frequently observed in PD and associated with prolonged survival when identified in MSA. Abnormal patterns were predominant in MSA. The most severe pattern was associated with the highest likelihood of MSA diagnosis and with the worst prognosis in the MSA cohort. MSA patients with EAS abnormalities often showed urogenital symptoms and fecal incontinence. Conclusions The increasing severity of EAS electromyography patterns paralleled diagnostic accuracy and survival in MSA, and correlated with prevalence of bladder and bowel symptoms. © 2022 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society

The High Value of External Anal- and Urethral-Sphincter Electromyography in Differential Diagnosis with MSA-P, PD, and PSP

“…[ 19 ] The more serious the electromyography changes are, the more likely the diagnosis of MSA will be, and the worse the prognosis of patients will be. [ 20 ] In our study, there was no statistical difference in the course of disease among the three groups. According to the average duration of MUPs in EAS-EMG and US-EMG, MSA-P had the longest average duration of MUP, followed by PSP and PD, which was consistent with the results of previous studies.…”

External Anal- and Urethral-Sphincter Electromyography for Differentiating MSA-P, PD and PSP: Using a Needle to Sort the Haystack!

“…[ 16 ] Recently, Todisco et al . [ 17 ] has explored the prognostic significance of EAS- EMG alterations in MSA and its co-relation with prevalence of bowel/bladder symptoms and poor outcome. Many studies have found EAS-EMG easier and better tolerated by patients when compared to urethral sphincter (US)-EMG.…”