[Pubmed] Beyond Jitter: Spike Count Analysis for Differentiating Botulinum Toxin and Myasthenic Effects on Neuromuscular

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J Clin Neurophysiol. 2025 Apr 16. doi: 10.1097/WNP.0000000000001164. Online ahead of print.

ABSTRACT

PURPOSE: Single-fiber electromyography is the most sensitive tool for diagnosing neuromuscular diseases but is limited in differentiating between presynaptic and postsynaptic neuromuscular junction involvement with increased jitter. With rising botulinum toxin (BoNT) use for therapeutic and cosmetic applications, referrals for electromyography because of myasthenia-like symptoms have increased, complicating differential diagnosis. This study examines whether spike count measurements from single-use concentric needle electrodes can distinguish BoNT effects from neuromuscular junction diseases such as myasthenia gravis.

METHODS: We analyzed 49 patients and 26 controls, assessing jitter and spike count with concentric needle electrodes in the frontalis muscle. Groups included those exposed to BoNT (>1 month and 1 month, suggesting a differentiation point from primary neuromuscular involvement. In contrast, patients with myasthenia gravis exhibited increased jitter without increased spike counts.

CONCLUSIONS: These findings indicate that spike count analysis with concentric needle electrodes may aid in differentiating iatrogenic BoNT effects from primary neuromuscular junction disorders, such as myasthenia gravis. However, further studies with larger sample sizes are necessary to validate these results.

PMID:40237607 | DOI:10.1097/WNP.0000000000001164


Source: https://pubmed.ncbi.nlm.nih.gov/4023760 ... t9+e462414