[Pubmed] Is the decrement pattern in myasthenia gravis due to muscle-specific kinase antibodies different to that due to

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Neurophysiol Clin. 2025 Jul 30;55(6):103092. doi: 10.1016/j.neucli.2025.103092. Online ahead of print.

ABSTRACT

OBJECTIVE: A decrement on repetitive nerve stimulation (RNS) is essential for the diagnosis of myasthenia gravis (MG). The decrement pattern is typically "U-shaped" in MG caused by acetylcholine receptor antibodies (AChR-MG) but is less well described in MG caused by muscle-specific kinase antibodies (MuSK-MG). The aim of this study was to investigate RNS abnormalities in MuSK-MG, and to describe the differences in the decrement pattern as compared to AChR-MG.

METHODS: This retrospective case-control study included patients diagnosed with generalized MuSK-MG, compared to a control group of generalized AChR-MG. The five most frequently explored nerve-muscle pairs in RNS were analyzed: radial-anconeus, fibular nerve-tibialis anterior (TA), XI-trapezius, XII/V-submental complex (SMC), and VII-orbicularis oculi (OO). Decreased amplitude between the 1st and 4th responses (early decrement) and the late/early ratio were calculated (late/early ratio

Source: https://pubmed.ncbi.nlm.nih.gov/4074358 ... t9+e462414