Literature review of the usefulness of repetitive nerve stimulation and single fiber EMG in the electrodiagnostic evaluation of patients with suspected myasthenia gravis or Lambert‐Eaton myasthenic syndrome
- 2 August 2001
- journal article
- review article
- Published by Wiley in Muscle & Nerve
- Vol. 24 (9), 1239-1247
- https://doi.org/10.1002/mus.1140
Abstract
A retrospective literature review of the electrodiagnosis of myasthenia gravis (MG) and Lambert–Eaton myasthenic syndrome (LEMS) through July 1998 was performed for the purpose of generating evidence‐based practice parameters. There were 545 articles identified, of which 13 articles met at least three of the six criteria set previously by the American Association of Electrodiagnostic Medicine (AAEM). An additional 21 articles were identified from review articles or the references of these first 13 articles leading to a total of 34 articles. Results of studies utilizing repetitive nerve stimulation (RNS) showed that a 10% decrement in amplitude from the first to fourth or fifth intravolley waveform while stimulating at 2–5 HZ is valid for the diagnosis of MG. The degree of increment needed for the diagnosis of LEMS is at least 25% but most accurate when greater than 100%. Abnormal jitter or impulse blocking are the appropriate criteria for diagnosis of neuromuscular junction (NMJ) disorders when using single fiber electromyography (SFEMG). SFEMG is more sensitive than RNS for the diagnosis of disorders of neuromuscular transmission, but may be less specific and may not be available. Therefore, RNS remains the preferred initial test for MG and LEMS. © 2001 American Association of Electrodiagnostic Medicine Muscle Nerve 24: 1239–1247, 2001Keywords
This publication has 35 references indexed in Scilit:
- Single fiber electromyography of extraocular muscles: A sensitive method for the diagnosis of ocular myasthenia gravisMuscle & Nerve, 1995
- Jitter of the stimulated motor axonMuscle & Nerve, 1992
- Technical artifact simulating ?Motor Axonopathy?Muscle & Nerve, 1992
- Single motor end‐plates in myasthenia gravis and lems at different firing ratesMuscle & Nerve, 1991
- Double-step repetitive stimulation in myasthenia gravisMuscle & Nerve, 1987
- AAEE Minimonograph #25: Single‐fiber electromyography in myasthenia gravisMuscle & Nerve, 1986
- Single fibre electromyographic studies in myasthenia gravis with repetitive nerve stimulation.Journal of Neurology, Neurosurgery & Psychiatry, 1975
- TEMPERATURE AND WEATHER CORRELATES OF MYASTHENIC FATIGUEThe Lancet, 1974
- ELECTRICAL TESTING IN MYASTHENIA GRAVIS*Annals of the New York Academy of Sciences, 1971
- Effects of Hypothalamic Lesions on the Erythropoietic Response to Hypoxia in Rabbits1Acta Physiologica Scandinavica, 1964