Lu sur http://onlinelibrary.wiley.com/wol1/doi ... 4/abstract
Traduction disponible directement en cliquant en bas à droite de ce message sur notre forum
New strategy for improving the diagnostic sensitivity of repetitive nerve stimulation in myasthenia gravis
Hanna Bou Ali MD1,2,†, Emmanuelle Salort-Campana MD1,2,3,†,*, Aude Marie Grapperon MD1,2, Julien Gallard MD1, Jerome Franques MD1, Amandine Sevy MD1,3, Emilien Delmont MD, PhD1,3, Annie Verschueren MD1,3, Jean Pouget MD1,2,3 andShahram Attarian MD, PhD1,2,3
Version of Record online: 3 JAN 2017 DOI: 10.1002/mus.25374
Muscle Nerve, 2016
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.
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.
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.
We recommend bilateral exploration of at least 3 muscles, a facial muscle, trapezius, and anconeus.