Evoked responses of the elbow flexors in control subjects and in myopathy patients

Electrical and mechanical responses were evoked in the elbow flexors (EFs) of normal subjects and myopathy patients by maximal stimulation of the musculocutaneous nerve by a wire electrode in the axilla. In normals, the decrement in the mechanical responses during short trains of twitches was small (10%). The potentiation during a staircase decreased with increasing frequency of stimuli, but the potentiation 30 sec after the 100-sec staircase was the same at all frequencies. Posttetanic potentiation was twice as large as the maximal potentiation attained during the staircase. The staircase phenomenon probably results from two opposing events, diminution and potentiation. Findings in 11 patients with myopathy varied according to the severity of involvement. Slight weakness of the EFs was associated with an increased twitch:tetanus ratio, decreased tetanic tension, and decrease in the staircase and posttetanic potentiation. Additionally, severe weakness of the EFs was associated with a diminution in twitch tension.