The difficulty in confirming clinical diagnosis of myasthenia gravis in a seronegative patient: a possible neurophysiological approach.
Neuromuscul Disord
; 19(12): 825-7, 2009 Dec.
Article
em En
| MEDLINE
| ID: mdl-19846306
ABSTRACT
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 3 Hz repetitive nerve stimulation at Erb's point and voluntary single-fibre EMG in the orbicularis oculi. We also performed 6 and 12 Hz 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 3 Hz and/or stimulated single-fibre EMG with an increasing stimulation rate may be helpful.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Estimulação Elétrica Nervosa Transcutânea
/
Músculo Esquelético
/
Eletromiografia
/
Miastenia Gravis
Tipo de estudo:
Diagnostic_studies
Idioma:
En
Revista:
Neuromuscul Disord
Ano de publicação:
2009
Tipo de documento:
Article
País de afiliação:
Itália