Sensitivity of @entity9808 of cortico-bulbar vs. cortico-spinal tract involvement in @entity746 ( XXXX ).

@entity1 @entity75 @entity9808 @entity4681 @entity746
BACKGROUND: An upper motor neuron (UMN) lesion in @entity746 ( @entity746 ) is often difficult to identify because clinical signs may be discrete or masked by severe simultaneous @entity75 . We compared the diagnostic sensitivity of @entity9808 ( @entity9808 ) to cranial muscles and limb muscles in the detection of UMN lesions. DESIGN: We investigated corticobulbar and corticospinal tract function to the tongue/orofacial muscles and abductor digiti minimi/tibial anterior muscles with @entity9808 in 51 @entity1 with @entity746 to compare the diagnostic yield in the detection of @entity4681 . An UMN lesion was assumed when the following were found: the peripheral conduction time and amplitude of the M-wave were within the normal range, the response to cortical stimulation was absent, the @entity9808 evoked/M-wave amplitude ratio was reduced, and the central motor conduction time or the interside difference was delayed (> mean+2.5 SD). RESULTS: On the basis of these criteria a UMN lesion to the orofacial muscles was identified in 24 @entity1 (47%), to the tongue in 27 (53%), and to the upper and lower limbs in 13 (25%) and 22 @entity1 (43%), respectively. Combined abnormalities from all sites increased the diagnostic yield to 39 @entity1 (76%). @entity9808 of the limb muscles confirmed a UMN lesion in only 15 (54%) of the 28 @entity1 with clinically confirmed UMN involvement. This number increased to 23 @entity1 (82%) if tongue and orofacial muscles were taken into acount. CONCLUSION: Our results indicate the early and in most cases subclinical corticobulbar tract involvement of the central motor pathways to the orofacial muscles and tongue in @entity746 . @entity9808 of the tongue and orofacial muscles had a higher sensitivity in identifying UMN lesions than that of the upper and lower limbs.
