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November 1978

Cervical Spondylitic Myelopathy

Author Affiliations

Rehabilitation Institute of Chicago 345 E Superior St Chicago, IL 60611

Arch Neurol. 1978;35(11):772. doi:10.1001/archneur.1978.00500350076017

To the Editor.—  In his article in the Archives (34:774-776, 1977) entitled "Cervical Spondylitic Myelopathy With Reversible Fasciculations in the Lower Extremities," Dr Kasdon summarizes his electromyographic findings with the repeated observation that no fibrillations were noted. Other studies1 show that the most sensitive indication of electromyographic abnormality and involvement of the motor fibers of a spinal nerve root is the presence of increased insertional activity, including positive sharp waves. There is no mention of either insertional activity or positive sharp waves in Dr Kasdon's article. As a result, it is impossible to properly consider his findings with regard to fasciculations. No mention was made of nerve conduction studies or of electrodiagnostic studies measuring Fwaves. Eisen et al2 have thoroughly reviewed the application of F wave measurements to the diagnosis of proximal neuropathies of the upper extremities. More research needs to be done before the role of fasciculations

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