The difficulty in confirming clinical diagnosis of myasthenia gravis in a seronegative patient: a possible neurophysiological approach
2009 (English)In: Neuromuscular Disorders, ISSN 0960-8966, E-ISSN 1873-2364, Vol. 19, no 12, 825-827 p.Article in journal (Refereed) Published
In seronegative myasthenia gravis repetitive nerve stimulation and single-fibre EMG have a crucial diagnostic value but they may be negative, particularly in repetitive nerve stimulation studies. We report the case of a 43-year-old patient with generalized seronegative myasthenia gravis with negative 3Hz repetitive nerve stimulation at Erb’s point and voluntary single-fibre EMG in the orbicularis oculi. We also performed 6 and 12Hz repetitive nerve stimulation at Erb and stimulated single-fibre EMG in the extensor digitorum communis and our findings were pathological. Our data suggest that, for individual patients with an atypical picture characterised by dissociation between a severe clinical pattern and no definite neurophysiological findings on conventional tests, repetitive nerve stimulation with a stimulation rate higher than 3Hz and/or stimulated single-fibre EMG with an increasing stimulation rate may be helpful.
Place, publisher, year, edition, pages
2009. Vol. 19, no 12, 825-827 p.
Myasthenia gravis, Singe fibre, Repetitive nerve stimulation
Research subject Clinical Neurophysiology
IdentifiersURN: urn:nbn:se:uu:diva-120676DOI: 10.1016/j.nmd.2009.09.005ISI: 000272874600005PubMedID: 19846306OAI: oai:DiVA.org:uu-120676DiVA: diva2:303813