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Terminal Innervation Ratio in Neuromuscular DiseaseII. Disorders of Lower Motor Neuron, Peripheral Nerve, and Muscle
Christian Coërs, MD;
Nicole Telerman-Toppet, MD;
Jean-Marie Gerard, MD
Arch Neurol. 1973;29(4):215-222.
Abstract
Terminal innervation ratio (TIR) of axons was measured in 251 neuromuscular biopsy specimens. In those from weak or atrophic muscles in denervation, TIR could not be measured in 15% owing to rarefaction of axons and paucity of motor endings. In remaining specimens, it was increased in 97%. Specimens from normal muscles with neuropathy showed increased TIR in 74%.
In samples from muscular dystrophies, TIR was normal in 82%, including all cases of Duchenne dystrophy. In some limb girdle and facioscapulohumeral syndromes, an increased TIR suggested a neural disorder. In myotonic dystrophy, mean TIR was significantly greater than in controls and exceeded normal in five cases.
Mean TIR was normal in 41 cases of myasthenia. It was slightly greater than normal in two cases. In acquired myopathy mean TIR was significantly increased, presumably in response to intramuscular denervation.
Author Affiliations
Brussels
From the Department of Neurology, Medical Clinic, Brugmann Hospital—Unité de Neurologie médico-chirurgicale, Brussels University, Brussels.
Footnotes
Accepted for publication May 22, 1973.
Reprint requests to Department of Neurology, Medical Clinic, Brugmann Hospital, Brussels (Dr. Coërs).
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