Concentric needle jitter on stimulated frontalis and extensor digitorum in 20 myasthenia gravis patients

Authors

  • João Aris Kouyoumdjian MD, PhD,

    Corresponding author
    1. Department of Neurological Sciences, Neuromuscular Investigation Laboratory, Faculdade de Medicina de São José do Rio Preto, Rua Luiz Antônio da Silveira 1661, 15025-020 São José do Rio Preto, São Paulo, Brazil
    • Department of Neurological Sciences, Neuromuscular Investigation Laboratory, Faculdade de Medicina de São José do Rio Preto, Rua Luiz Antônio da Silveira 1661, 15025-020 São Paulo, Brazil
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  • Adriana Cristina da Silva Fanani MD,

    1. Department of Neurological Sciences, Neuromuscular Investigation Laboratory, Faculdade de Medicina de São José do Rio Preto, Rua Luiz Antônio da Silveira 1661, 15025-020 São José do Rio Preto, São Paulo, Brazil
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  • Erik V. Stålberg MD, PhD

    1. Department of Clinical Neurophysiology, Institute of Neurosciences, Uppsala University, Uppsala, Sweden
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Abstract

Introduction: Our objective was to study jitter parameters using a concentric needle electrode (CNE) in the extensor digitorum (ED) and frontalis (FR) muscles. Methods: Twenty myasthenia gravis (MG) patients, mean age 44.5 years, were studied. Percutaneous (FR) and intramuscular needle (ED) stimulation approaches were used. Jitter was expressed as the mean consecutive difference (MCD). The filter settings were from 1000 HZ to 10 kHZ. Results: Abnormal MCD was found in 85% for both ED and FR and in 90% when combining the two muscles. An abnormal percentage of outliers was found in 90% for ED and 85% for FR. The mean MCD did not show a difference for ED and FR, but the percentage of outliers and blocking were higher in FR. Abnormality was found in 93.7% (generalized) and in 75% (ocular) of MG cases. For ED outliers abnormality was greater than the MCD. Conclusion: CNE jitter is reliable for investigation of MG, although borderline findings should be judged with caution. Muscle Nerve 2011

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