Diagnostic accuracy of thoracic paraspinal electromyography in amyotrophic lateral sclerosis

Achraf A. Makki, Michael Benatar

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


The goal of this study was to estimate the accuracy of thoracic paraspinal (T-PSP) electromyography (EMG), performed at the time of initial evaluation, for the subsequent clinical diagnosis of amyotrophic lateral sclerosis (ALS). Medical records from a consecutive series of patients referred for suspected ALS were abstracted. Those in whom T-PSP EMG was not performed or for whom follow-up was not available were excluded. The study population included 64 patients. T-PSP EMG was abnormal in 28 (44%) study patients, 26 (93%) of whom were subsequently diagnosed with ALS. T-PSP EMG showed neither fibrillation potentials nor positive sharp waves in 36 (56%) patients, 9 (25%) of whom later developed ALS. The sensitivity of T-PSP for the diagnosis of ALS was 0.74 and the specificity was 0.93. The likelihood ratio positive was 10.5 and the likelihood ratio negative was 0.28. These results suggest that T-PSP EMG is very useful for "ruling in" the diagnosis of ALS, but less useful as a screening test for "ruling out" the diagnosis. Because T-PSP EMG is used clinically in an effort to confirm the diagnosis (and not as a screening test), these results suggest that T-PSP EMG is an extremely useful adjunct for the diagnosis of ALS.

Original languageEnglish (US)
Pages (from-to)298-300
Number of pages3
JournalJournal of Clinical Neurophysiology
Issue number3
StatePublished - Jun 1 2007
Externally publishedYes


  • ALS
  • Electromyography
  • Likelihood ratio
  • Paraspinal
  • Sensitivity
  • Specificity

ASJC Scopus subject areas

  • Clinical Neurology
  • Physiology
  • Neuroscience(all)


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