Document Detail


Use of repetitive nerve stimulation in the evaluation of neuromuscular junction disorders.
MedLine Citation:
PMID:  16457051     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Neuromuscular junction (NMJ) disorders are characterized by fuctuating muscle weakness. Acquired myasthenia gravis is the most common NMJ disorder with an overall prevalence in United States estimated at 60,000. Depending on the site of neuromuscular transmission failure, NMJ disorders have been classified as: (1) presynaptic (e.g., Lambert-Eaton myasthenic syndrome), (2) synaptic (e.g., cholinesterase inhibitor toxicity), and (3) post-synaptic (e.g., myasthenia gravis). Electrodiagnostic techniques used for investigation of NMJ disorders include repetitive nerve stimulation (RNS) and single fiber electromyography (SFEMG). Recent literature widely explores the use of SFEMG in the diagnosis and monitoring of myasthenia gravis, but this technique has a lesser role in the daily clinical practice outside of academic institutions. RNS is not as sensitive as SFEMG, but it is the most widely used electrodiagnostic method in the evaluation of suspected neuromuscular transmission disorders. RNS is technically easier and does not require special technical training and skill as SFEMG. Repetitive nerve stimulation was utilized first by Jolly in 1895 using an electrical drum and faradic tetanization to demonstrate a "myasthenic reaction" (weakening muscle contractions). In 1941, decremental response following the repetitive nerve stimulation was described by Harvey and Masland. While the technology has improved tremendously since then, the RNS testing is still based on supramaximal repetitive nerve stimulation and the measurement of decremental (or incremental) responses.
Authors:
Sasa A Zivković; Carol Shipe
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  American journal of electroneurodiagnostic technology     Volume:  45     ISSN:  1086-508X     ISO Abbreviation:  Am J Electroneurodiagnostic Technol     Publication Date:  2005 Dec 
Date Detail:
Created Date:  2006-02-06     Completed Date:  2006-02-28     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9607038     Medline TA:  Am J Electroneurodiagnostic Technol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  248-61     Citation Subset:  IM    
Affiliation:
Veterans Administration Pittsburgh Healthcare System and University of Pittsburgh School of Medicine Pittsburgh, Pennsylvania 15213, USA.
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MeSH Terms
Descriptor/Qualifier:
Electric Stimulation / methods*
Electromyography / methods*
Humans
Muscle, Skeletal / innervation*
Neuromuscular Junction Diseases / diagnosis*
Physician's Practice Patterns
Practice Guidelines as Topic
Synaptic Transmission*

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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