Diagnostic Sensitivity of Repetitive Nerve Stimulation Test in Myasthenia Gravis.
- Author:
Sang Ahn LEE
1
;
Ki Han KWON
;
Il Nam SUNWOO
Author Information
1. Department of Neurology, College of Medicine, Yonsei University, Korea.
- Publication Type:Original Article
- MeSH:
Action Potentials;
Muscles;
Myasthenia Gravis*;
Superficial Back Muscles
- From:Journal of the Korean Neurological Association
1993;11(2):195-201
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Repetitive nerve stimulation (RNS) test was systematically performed in proximal and distal muscles of 142 cases with myasthenia gravis (MG) and 45 norrnal controls and then analyzed qualitatively. Diagnostic sensitivity was 75% based on abnorrnal decremental response in at least one muscle. The sensitivity increased from 56% in ocular MG to 96% in type Iib MG according to severity of disease. Higher diagnostic yield was noted in the orbiculans oculi in ocular MG and in the trapezius in gereralized MG. RNS test on proximal muscle showed a higher positive rate than that on distal muscles. When distal muscle testing was negative, there was an additional increase of 24% in proximal muscle testing. The posttetanic exhaustion (PTE) enhanced diagnostic sensitivitY as much as 8% in generalized MG. The posttetanic facilitation(PTF) and PTE were observed in 50% and 38% of generalized MG and were most prominent in MG with moderate severity. Five patterns on RNS findings were classified according to test paramcters. The most common response was the pattern which showed normal arnplitude of compound muscle action potential, decremental response at low rate stimulation, and PTF without PTE.
