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Repetitive nerve stimulation test in myasthenic crisis
Shin J Oh1, Dushin Jeong1,2, Ikjae Lee1
1Department of Neurology, University of Alabama at Birmingham, UAB Station, Birmingham, Alabama, 35294, USA.
Muscle & Nerve
|November 30, 2018
Summary
The repetitive nerve stimulation (RNS) test is a rapid and sensitive diagnostic tool for myasthenia gravis (MG) crisis. In 92% of patients, RNS tests showed abnormalities, aiding in diagnosing MG crisis effectively.
Area of Science:
- Neurology
- Clinical Electrophysiology
Background:
- Myasthenia gravis (MG) crisis is a severe exacerbation requiring prompt diagnosis.
- The utility of repetitive nerve stimulation (RNS) testing in this acute setting is crucial.
Purpose of the Study:
- To evaluate the diagnostic value of RNS testing in patients experiencing myasthenia gravis crisis.
Main Methods:
- Analysis of RNS test parameters in 26 patients diagnosed with MG crisis.
- Assessment of nerve conduction and muscle response during low-rate stimulation.
Main Results:
- RNS tests were abnormal in 92% of patients with MG crisis.
- The most common abnormality observed was the 'MG pattern' (decrement at low-rate stimulation), seen in 23 patients.
- In 69% of cases, MG crisis was the initial presentation of myasthenia gravis.
Conclusions:
- Repetitive nerve stimulation (RNS) testing is a valuable and sensitive tool for the rapid diagnosis of myasthenia gravis crisis.
- The RNS test can differentiate between MG crisis, Lambert-Eaton myasthenic syndrome, and cholinergic crisis.
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