<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>1665-5044</journal-id>
<journal-title><![CDATA[Revista mexicana de neurociencia]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. mex. neurocienc.]]></abbrev-journal-title>
<issn>1665-5044</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Neurología A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S1665-50442021000400141</article-id>
<article-id pub-id-type="doi">10.24875/rmn.20000135</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[Split hand phenomenon: An early marker for amyotrophic lateral sclerosis]]></article-title>
<article-title xml:lang="es"><![CDATA[Fenómeno de mano dividida: Un marcador temprano de esclerosis lateral amiotrófica]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Galnares-Olalde]]></surname>
<given-names><![CDATA[Javier A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Hernández]]></surname>
<given-names><![CDATA[Juan C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Saráchaga-Adib]]></surname>
<given-names><![CDATA[Jorge de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Cervantes-Uribe]]></surname>
<given-names><![CDATA[Roberto]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vargas-Cañas]]></surname>
<given-names><![CDATA[Edwin S.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez Department of Neurology ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez Department of Neuromuscular Disease ]]></institution>
<addr-line><![CDATA[Mexico City ]]></addr-line>
<country>Mexico</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>08</month>
<year>2021</year>
</pub-date>
<volume>22</volume>
<numero>4</numero>
<fpage>141</fpage>
<lpage>145</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S1665-50442021000400141&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S1665-50442021000400141&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S1665-50442021000400141&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Background: Amyotrophic lateral sclerosis (ALS) is a progressive disease characterized by degeneration of upper and lower motor neurons. Time from symptom onset to confirmed diagnosis has been reported from 8 to 15 months in ALS.  Objectives: To describe the frequency of the split hand phenomenon and propose it as an early biomarker for ALS diagnosis.  Methods: A retrospective, analytical, descriptive, and single-center observational study was performed. The split hand ratio was determined by dividing distal abductor pollicis brevis/abductor digit minimi compound muscle action potentials; a result &lt; 0.6 was considered present.  Results: Fifty-four patients with ALS diagnosis were included in the study. The split hand ratio was identified in 61.5% of patients with definite ALS, in 68.7% with probable ALS, 80% with possible ALS, and in 50% with suspected ALS. The split hand phenomenon was identified in 60% of patients within 12 months of symptom onset.  Conclusion: We provide evidence for an additional neurophysiological tool that helps early diagnosis of ALS.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Antecedentes: La esclerosis lateral amiotrófica (ELA) es una enfermedad progresiva caracterizada por la degeneración de las neuronas motoras superiores e inferiores. Se ha reportado que el tiempo desde el inicio de los síntomas hasta el diagnóstico confirmado es de 8 a 15 meses.  Objetivo: Describir la frecuencia del fenómeno de mano dividida en las etapas iniciales de la enfermedad y proponerlo como un marcador temprano para el diagnóstico.  Métodos: se realizó un estudio observacional retrospectivo, analítico, descriptivo y unicéntrico. La relación de mano dividida se determinó dividiendo los potenciales de acción compuestos motores distales entre abductor pollicis brevis/abductor digit minimi (APB/ADM); se consideró presente un resultado &lt;0.6.  Resultados: Se incluyeron cincuenta y cuatro pacientes con diagnóstico de ELA. El fenómeno de mano dividida se identificó en el 61.5% de los pacientes con ELA definida, en el 68.7% con ELA probable, el 80% con ELA posible y en el 50% con sospecha de ELA. El fenómeno de la mano dividida se identificó en el 60% de los pacientes dentro de los primeros 12 meses tras el inicio de síntomas.  Conclusión: Proporcionamos evidencia para una herramienta neurofisiológica en la ayuda del diagnóstico temprano de ELA.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Amyotrophic lateral sclerosis]]></kwd>
<kwd lng="en"><![CDATA[Motor neuron disease]]></kwd>
<kwd lng="en"><![CDATA[Split hand phenomenon]]></kwd>
<kwd lng="en"><![CDATA[El Escorial criteria]]></kwd>
<kwd lng="es"><![CDATA[Esclerosis lateral amiotrófica]]></kwd>
<kwd lng="es"><![CDATA[Enfermedad de la motoneurona]]></kwd>
<kwd lng="es"><![CDATA[Fenómeno de mano dividida]]></kwd>
<kwd lng="es"><![CDATA[El Escorial criteria]]></kwd>
</kwd-group>
</article-meta>
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