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December 1983, Vol 40, No. 13 >
Article | December 1983

Hand Muscle Atrophy in Multiple Sclerosis

Marc Fisher, MD; Randall R. Long, MD; David A. Drachman, MD
[+] Author Affiliations

Accepted for publication Jan 27, 1983.

Reprint requests to Worcester Memorial Hospital, 119 Belmont St, Worcester, MA 01605 (Dr Fisher).


Arch Neurol. 1983;40(13):811-815. doi:10.1001/archneur.1983.04050120061009
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• The occurrence of muscular atrophy in multiple sclerosis (MS) has been considered unusual and classically has been ascribed to disease involving the motor unit. Nine patients with MS in a single clinic were found by strict criteria to have focal hand muscle atrophy associated with weakness. None had electrodiagnostic evidence of either anterior horn cell or axonal abnormalities. These observations indicate that focal muscular atrophy is common in MS; it may often occur as a result of relative disuse resulting from disease of central pathways involved in motor control.

REFERENCES

1 +
Poser CM:  Diseases of the myelin sheath , in Baker AB, Baker LH (eds): Clinical Neurology . Hagerstown, Md, Harper & Row Publishers Inc, 1978;, vol 2, pp 4-70.
2 +
Garcin R, Lapresle J, Fardeau M:  Documents pour servis àl'étude des amyotrophies et des abolition durable des réflexes tendineux observées dans la sclérose en plaques . Rev Neurol 1962;;107:417-431.
3 +
Hasson J, Terry RD, Zimmerman H:  Peripheral neuropathy in multiple sclerosis . Neurology 1958;;8:503-510.
4 +
Dales S, Ebers G, Feasby T, et al:  International symposium on multiple sclerosis . Can J Neurol Sci 1981;;8:333-338.
5 +
Hammer K: Nerve Conduction Studies . Springfield, Ill, Charles C Thomas Publisher, 1982;.
6 +
Medical Research Council: Aids to Examination of the Peripheral Nervous System . London, Her Majesty's Stationery Office, 1976;.
7 +
Pitres A:  Contribution à l'étude des anomalies de la sclérose en plaques dissémineés . Rev Med 1877;;1:893-907.
8 +
Lejonne P: Contributions a l'étude des atrophies musculaires dans la sclérose en plaques, thesis. Paris, 1903.
9 +
Kurtzke JF, Beebe GW, Nagler B, et al:  Studies on the natural history of multiple sclerosis . Acta Neurol Scand 1972;;48:19-46.
10 +
Davison C, Goodhart SP, Lander J:  Multiple sclerosis and amyotrophies . Arch Neurol Psychiatry 1934;;31:270-289.
11 +
Friedman AP, Davison C:  Multiple sclerosis with late onset of symptoms . Arch Neurol Psychiatry 1945;;54:348-360.
12 +
Bonduelle M, Bouygues P, Chaumont P:  Amyotrophies et abolition des réflexes dans la sclérose en plaque . Sem Hop Paris 1964;;13:814-821.
13 +
Lumsden CE:  The neuropathology of multiple sclerosis , in Vinken PJ, Bruyn GW (eds): Handbook of Clinical Neurology , vol 9. Amsterdam, North-Holland Publishing Co, 1970;, vol 9, pp 217-309.
14 +
Pollack M, Calder C, Allpress S:  Peripheral nerve abnormalities in multiple sclerosis . Ann Neurol 1977;;2:41-48.
15 +
Taraschi G, Lanzi G:  Motor nerve conduction velocity in multiple sclerosis . Electroencephalogr Clin Neurophysiol 1962;;22:54-55.
16 +
Hopf HC, Eysholdt M:  Impaired refractory periods of peripheral sensory nerves in multiple sclerosis . Ann Neurol 1978;;4:499-501.
17 +
Weir AI, Hansen S, Ballantyne JP:  The single fiber electromyographic jitter in multiple sclerosis . J Neurol Neurosurg Psychiatry 1979;; 42:1146-1150.
18 +
Weir AI, Hansen S, Ballantyne JP:  Motor unit abnormalities in multiple sclerosis: Further evidence of a peripheral nervous system defect . J Neurol Neurosurg Psychiatry 1980;;43:999-1004.
19 +
Hall M: Lectures on the Nervous System and Its Disease . Philadelphia, EL Carey & A Hat, 1836;, p 240.
20 +
Guthrie L:  Muscular atrophy and other changes in nutrition associated with lesions of the sensory cortex of the brain, with bifocal reference to the existence of trophic representation in the post central areas . Proc R Soc Med 1918;;11:21-26.
21 +
Silverstein A:  Diagnostic localizing value of muscle atrophy in parietal lobe lesions . Neurology 1955;;5:30-55.
22 +
Winkelman NW, Silverstein A:  Trophic disturbances of the limbs in retro-rolandic lesions . Assoc Res Nerv Dis Proc 1932;;13:485-528.
23 +
Chokroverty S, Reyes MG, Rubino FA, et al:  Hemiplegic amyotrophy . Arch Neurol 1976;; 33:104-110.
24 +
Fenichel GM, Daroff RB, Glaser GH:  Hemiplegic atrophy: Histological and biologic considerations . Neurology 1964;;14:883-890.
25 +
Drachman DB:  The role of acetylcholine as a neurotrophic transmitter . Ann NY Acad Sci 1974;;228:160-177.

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1 +
Poser CM:  Diseases of the myelin sheath , in Baker AB, Baker LH (eds): Clinical Neurology . Hagerstown, Md, Harper & Row Publishers Inc, 1978;, vol 2, pp 4-70.
2 +
Garcin R, Lapresle J, Fardeau M:  Documents pour servis àl'étude des amyotrophies et des abolition durable des réflexes tendineux observées dans la sclérose en plaques . Rev Neurol 1962;;107:417-431.
3 +
Hasson J, Terry RD, Zimmerman H:  Peripheral neuropathy in multiple sclerosis . Neurology 1958;;8:503-510.
4 +
Dales S, Ebers G, Feasby T, et al:  International symposium on multiple sclerosis . Can J Neurol Sci 1981;;8:333-338.
5 +
Hammer K: Nerve Conduction Studies . Springfield, Ill, Charles C Thomas Publisher, 1982;.
6 +
Medical Research Council: Aids to Examination of the Peripheral Nervous System . London, Her Majesty's Stationery Office, 1976;.
7 +
Pitres A:  Contribution à l'étude des anomalies de la sclérose en plaques dissémineés . Rev Med 1877;;1:893-907.
8 +
Lejonne P: Contributions a l'étude des atrophies musculaires dans la sclérose en plaques, thesis. Paris, 1903.
9 +
Kurtzke JF, Beebe GW, Nagler B, et al:  Studies on the natural history of multiple sclerosis . Acta Neurol Scand 1972;;48:19-46.
10 +
Davison C, Goodhart SP, Lander J:  Multiple sclerosis and amyotrophies . Arch Neurol Psychiatry 1934;;31:270-289.
11 +
Friedman AP, Davison C:  Multiple sclerosis with late onset of symptoms . Arch Neurol Psychiatry 1945;;54:348-360.
12 +
Bonduelle M, Bouygues P, Chaumont P:  Amyotrophies et abolition des réflexes dans la sclérose en plaque . Sem Hop Paris 1964;;13:814-821.
13 +
Lumsden CE:  The neuropathology of multiple sclerosis , in Vinken PJ, Bruyn GW (eds): Handbook of Clinical Neurology , vol 9. Amsterdam, North-Holland Publishing Co, 1970;, vol 9, pp 217-309.
14 +
Pollack M, Calder C, Allpress S:  Peripheral nerve abnormalities in multiple sclerosis . Ann Neurol 1977;;2:41-48.
15 +
Taraschi G, Lanzi G:  Motor nerve conduction velocity in multiple sclerosis . Electroencephalogr Clin Neurophysiol 1962;;22:54-55.
16 +
Hopf HC, Eysholdt M:  Impaired refractory periods of peripheral sensory nerves in multiple sclerosis . Ann Neurol 1978;;4:499-501.
17 +
Weir AI, Hansen S, Ballantyne JP:  The single fiber electromyographic jitter in multiple sclerosis . J Neurol Neurosurg Psychiatry 1979;; 42:1146-1150.
18 +
Weir AI, Hansen S, Ballantyne JP:  Motor unit abnormalities in multiple sclerosis: Further evidence of a peripheral nervous system defect . J Neurol Neurosurg Psychiatry 1980;;43:999-1004.
19 +
Hall M: Lectures on the Nervous System and Its Disease . Philadelphia, EL Carey & A Hat, 1836;, p 240.
20 +
Guthrie L:  Muscular atrophy and other changes in nutrition associated with lesions of the sensory cortex of the brain, with bifocal reference to the existence of trophic representation in the post central areas . Proc R Soc Med 1918;;11:21-26.
21 +
Silverstein A:  Diagnostic localizing value of muscle atrophy in parietal lobe lesions . Neurology 1955;;5:30-55.
22 +
Winkelman NW, Silverstein A:  Trophic disturbances of the limbs in retro-rolandic lesions . Assoc Res Nerv Dis Proc 1932;;13:485-528.
23 +
Chokroverty S, Reyes MG, Rubino FA, et al:  Hemiplegic amyotrophy . Arch Neurol 1976;; 33:104-110.
24 +
Fenichel GM, Daroff RB, Glaser GH:  Hemiplegic atrophy: Histological and biologic considerations . Neurology 1964;;14:883-890.
25 +
Drachman DB:  The role of acetylcholine as a neurotrophic transmitter . Ann NY Acad Sci 1974;;228:160-177.

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