RESUMO
INTRODUCTION: 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.
Assuntos
Estimulação Elétrica/métodos , Músculo Esquelético/fisiopatologia , Miastenia Gravis/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Autoanticorpos/sangue , Eletromiografia , Ácidos Graxos Monoinsaturados/imunologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Exame Neurológico , Receptores Colinérgicos/imunologia , Estudos Retrospectivos , Sensibilidade e Especificidade , Índice de Gravidade de Doença , Adulto JovemAssuntos
Autoanticorpos/sangue , Encefalite/imunologia , Doença de Hashimoto/imunologia , Malária/complicações , Canais de Potássio de Abertura Dependente da Tensão da Membrana/imunologia , Adulto , Anti-Inflamatórios/uso terapêutico , Encefalite/tratamento farmacológico , Doença de Hashimoto/tratamento farmacológico , Humanos , Masculino , Metilprednisolona/uso terapêuticoRESUMO
Post-malaria neurological syndrome (PMNS) is a complication that occurs after recovery from a severe Plasmodium falciparum attack. Over the past two decades, the description of several imported cases has confirmed that this syndrome is a clearly distinct entity, different from other post malarial neurological disorders. However, the underlying mechanisms are not yet elucidated. Herein, we present five imported PMNS cases managed in Marseille, France. The detection of neuronal surface antibodies to an encephalitic syndrome of unknown origin allowed us to reveal positivity of anti Voltage-Gated-Potassium Channel antibodies (anti VGKC) in one of them. Using treatment options from other autoimmune encephalitis has to be explored in patients with PMNS.