Abstract
The diagnostic sensitivity of repetitive nerve stimulation (RNS) in patients with myasthenia gravis (MG) varies as the choice of muscles studied and method used as “gold standard” to judge sensitivity and specificity. Many research in MG-RNS studies for more high sensitivity were reported previously, almost generalized MG RNS sensitivity was from 60% to 80% slight more sensitive than serological study. We recommend RNS examination of at least 3 muscles, nasalis, trapezius, and deltoid. Sensitivity of RNS in generalized seropositive MG were 54%, 51%, 62%. The seronegativity of AChR frequency reported subsequently has ranged from 7% to 40% for all acquired MG patients, and from 6% to 30% for generalized MG. We hope RNS and SFEMG for diagnosis of MG could help to pick up from seronegative patients. SFEMG is one of the key, and combination of selection of examination for RNS is another key of diagnosis for MG. Pitfall of specificity of RNS is misdiagnosis of motor neuron disease decrement as same as neuromuscular transmission dysfunction. We should be aware of sensitivity of RNS for ALS is higher than MG except nasalis muscle.
Published Version
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