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Determining jitter values in the very young by use of the e-norms methodology

Matthew C Pitt1, Joe F Jabre2

  • 1Department of Clinical Neurophysiology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, WC1N 3JH, UK.

Muscle & Nerve
|May 18, 2016
PubMed

Insights

Diagnosing myasthenia gravis in infants is difficult. This study derived reference values for jitter mean consecutive difference (MCD) using the extrapolated norms (e-norms) method, providing crucial diagnostic data for young children.

Area of Science:

  • Neurology
  • Pediatric Electromyography

Background:

  • Diagnosing myasthenia gravis in infants presents significant challenges.
  • Stimulated single-fiber electromyography (StimSFEMG) is valuable but lacks reference values for infants.
  • This necessitates the development of normative data for pediatric populations.

Purpose of the Study:

  • To derive a reference range for jitter mean consecutive difference (MCD) in infants under 3 years of age.
  • To establish normative data for StimSFEMG in a pediatric cohort.
  • To address the diagnostic limitations in very young infants with suspected myasthenia gravis.

Main Methods:

  • Utilized the extrapolated norms (e-norms) technique to analyze data.
  • Calculated jitter MCD descriptive statistics for children under 3 years old.
  • Applied established statistical methods to derive reference values from existing cohorts.

Main Results:

  • Established upper limits for jitter MCD: 45 μs (<1 year), 33 μs (<2 years), and 26 μs (<3 years).
  • Provided specific reference ranges tailored to different age groups within the first three years of life.
  • Demonstrated the feasibility of the e-norms method for generating pediatric reference data.

Conclusions:

  • The e-norms method offers a viable alternative for deriving jitter reference values in infants.
  • These derived values can aid in the diagnosis of neuromuscular disorders in young children.
  • Addresses a critical gap in diagnostic tools for pediatric myasthenia gravis.
Abstract

Keywords:
e-normsjitterneuromuscular transmissionpediatricsingle-fiber EMG

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