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Timing of Decremental Response During Repetitive Nerve Stimulation in Myasthenia Gravis
Author(s) -
Gloria Ortiz Guerrero,
Andrew Heim,
Mamatha Pasnoor,
Laura Herbelin,
Omar Jawdat,
Melanie Glenn,
Jeffrey Statland,
Duaa Jabari,
Constantine Farmakidis,
Richard J. Barohn
Publication year - 2022
Publication title -
rrnmf neuromuscular journal
Language(s) - English
Resource type - Journals
ISSN - 2692-3092
DOI - 10.17161/rrnmf.v3i1.15216
Subject(s) - myasthenia gravis , repetitive nerve stimulation , medicine , stimulation , nerve stimulation , anesthesia
Background: A decrement >10% detected during repetitive nerve stimulation (RNS) is supportive of considering a diagnosis of myasthenia gravis (MG). Several studies have found that most of this decrement is seen between 4 to 6 min post-exercise. However, there are not available studies analyzing if shorter timing would be sufficient.   Objective: The objective of this study was to evaluate if RNS up to 2 min post-exercise is sufficient to detect a decrement response >10%. Methods: We performed a retrospective chart review study of patients referred to our neuromuscular clinic at The University of Kansas Medical Center with symptoms suggestive of MG from 2013 to 2017. Results: A total of 76 patients with MG and 100 controls were identified.  A significant decrement was detected in 95% of MG patients with abnormal RNS within 2 minutes post-exercise. Conclusion: RNS up to 2 min post-exercise might be sufficient to detect a significant decrement in MG patients. 

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