Premium
New strategy for improving the diagnostic sensitivity of repetitive nerve stimulation in myasthenia gravis
Author(s) -
Bou Ali Hanna,
SalortCampana Emmanuelle,
Grapperon Aude Marie,
Gallard Julien,
Franques Jerome,
Sevy Amandine,
Delmont Emilien,
Verschueren Annie,
Pouget Jean,
Attarian Shahram
Publication year - 2017
Publication title -
muscle and nerve
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.025
H-Index - 145
eISSN - 1097-4598
pISSN - 0148-639X
DOI - 10.1002/mus.25374
Subject(s) - myasthenia gravis , repetitive nerve stimulation , medicine , trapezius muscle , stimulation , accessory nerve , ocular myasthenia , electromyography , facial nerve , anatomy , physical medicine and rehabilitation
The diagnostic sensitivity of repetitive nerve stimulation (RNS) in patients with myasthenia gravis (MG) varies as a function of the number of muscles or the choice of muscles studied. Methods: By exploring 12 muscles bilaterally, we evaluated the global sensitivity of RNS at rest, the sensitivity in different clinical forms, and the sensitivity of different combinations of muscles studied. Results: The global sensitivity of RNS was 82%, and specificity was 100%. The sensitivity in the MG subgroups was as follows: ocular (O) = 67%; oculobulbar (OB) = 86%; and generalized (G) = 89%. The most sensitive muscles were the anconeus in group O, orbicularis oculi (OO) or nasalis in group OB, and the trapezius in group G. Maximum sensitivity was obtained by exploring OO, trapezius, and anconeus bilaterally. Conclusions: We recommend bilateral exploration of at least 3 muscles, a facial muscle, trapezius, and anconeus. Muscle Nerve 55 : 532–538, 2017