Lu sur :https://www.ncbi.nlm.nih.gov/pubmed/29189551
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Distinguishing Features of the Repetitive Nerve Stimulation Test Between Lambert-Eaton Myasthenic Syndrome and Myasthenia Gravis, 50-Year Reappraisal.
Oh SJ1.
J Clin Neuromuscul Dis. 2017 Dec;19(2):66-75. doi: 10.1097/CND.0000000000000190.
Abstract
- OBJECTIVE:
To reappraise the distinguishing features of the repetitive nerve stimulation (RNS) tests in the abductor digiti quinti muscle between myasthenia gravis (MG) and Lambert-Eaton myasthenic syndrome (LEMS) 50 years after the 1965's Lambert seminal paper.
- METHODS:
The various parameters of the RNS test were compared between 34 patients with LEMS and 140 patients with MG to assess their diagnostic sensitivity.
- RESULTS:
RNS test was abnormal in all (100%) patients with LEMS and 76 (54%) patients with MG. The diagnostic hallmark of LEMS, ≥60% increment at high-rate stimulation or postexercise facilitation, was present in 33 (97%) of patients. The diagnostic hallmark of MG, decrement at low-rate stimulation (LRS), was present in 65 (46%) of patients with MG. The most prominent difference in the various parameters of RNS tests was noted between LEMS versus MG and normal controls.
- CONCLUSIONS:
Distinguishing features of the RNS test in LEMS and MG are confirmed in this direct comparison study: the low compound muscle action potential amplitude, decrement at LRS, and increment at high-rate stimulation or postexercise facilitation for LEMS and normal compound muscle action potential amplitude and decrement at LRS for MG.
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