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

Faye Y. Chiou-Tan, Richard W. Tim, James M. Gilchrist, Cheryl F. Weber, John R. Wilson, Timothy J. Benstead, Arlene M. Braker, James B. Caress, Sudhansu Chokroverty, Earl R. Hackett Md, Robert L. Harmon, Bernadette A. Hughes, Milind J. Kothari, Tim Lachman, Richard I. Malamut, Christina M. Marciniak, Robert G. Miller, Kevin R. Nelson, Richard K. Olney, Atul T. PatelCaroline A. Quartly, Karen S. Ryan

Research output: Contribution to journalReview article

121 Scopus citations

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.

Original languageEnglish (US)
Pages (from-to)1239-1247
Number of pages9
JournalMuscle and Nerve
Volume24
Issue number9
DOIs
StatePublished - Jan 1 2001

Keywords

  • Lambert-Eaton myasthenic syndrome
  • Myasthenia gravis
  • Neuromuscular junction
  • Repetitive nerve stimulation
  • Single fiber electromyography

ASJC Scopus subject areas

  • Physiology
  • Clinical Neurology
  • Cellular and Molecular Neuroscience
  • Physiology (medical)

Fingerprint Dive into the research topics of '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'. Together they form a unique fingerprint.

  • Cite this

    Chiou-Tan, F. Y., Tim, R. W., Gilchrist, J. M., Weber, C. F., Wilson, J. R., Benstead, T. J., Braker, A. M., Caress, J. B., Chokroverty, S., Hackett Md, E. R., Harmon, R. L., Hughes, B. A., Kothari, M. J., Lachman, T., Malamut, R. I., Marciniak, C. M., Miller, R. G., Nelson, K. R., Olney, R. K., ... Ryan, K. S. (2001). 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. Muscle and Nerve, 24(9), 1239-1247. https://doi.org/10.1002/mus.1140