Boonhong Jariya
Department of Rehabilitation Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
J Med Assoc Thai. 2009 Jan;92(1):96-100.
To access the percentage of the patients whose repetitive nerve stimulation (RNS) studies were negative for 10% amplitude decrement but positive for 10% area decrement and to compare these disagreed results with specialist physician's diagnosis.
Retrospective descriptive study.
Electrodiagnosis laboratory, Department of Rehabilitation Medicine, King Chulalongkorn Memorial Hospital.
All of the electromyography (EMG) reports of RNS studies were reviewed Both 10% amplitude and area decrement were used as criteria for diagnosis in each patient. The disagreed results would be compared to final diagnosis of the specialist physicians that were recorded in out-patient medical records.
Eighty-three reports were included in the present study. Nineteen records (22.9%) were negative for 10% amplitude decrement but positive for 10% area decrement. Three records (3.6%) were positive for 10% amplitude decrement but negative for 10% area decrement. Twenty-two patients had disagreed results. Sixteen disagreed out-patient medical records (72.7%) were available for review the final specialist doctors' diagnosis. About 69% of patients, whose test was negative for 10% amplitude decrement but positive for 10% area decrement, were diagnosed as myasthenia gravis (MG) or suspected MG. All of the patients, whose test was negative for 10% area decrement but positive for 10% amplitude decrement, were diagnosed as MG. The use of both 10% amplitude and area decrement instead of 10% amplitude decrement alone will provide additional diagnostic yields in about 13% of the cases.
Twenty-three percent of patients had disagreed RNS results that were negative for 10% amplitude decrement but positive for 10% area decrement. When these disagreed results were compared to the final diagnosis of specialist doctors, 69% of these patients were diagnosed or suspected and treated as MG. Using both 10% amplitude and area decrement may improve sensitivity of MG diagnosis in about 13% of the cases.
评估重复神经电刺激（RNS）检查中10%波幅递减为阴性但10%面积递减为阳性的患者比例，并将这些不一致的结果与专科医生的诊断进行比较。
回顾性描述性研究。
朱拉隆功国王纪念医院康复医学科电诊断实验室。
回顾所有RNS检查的肌电图（EMG）报告。每位患者均以10%波幅递减和10%面积递减作为诊断标准。将不一致的结果与门诊病历中记录的专科医生的最终诊断进行比较。
本研究纳入83份报告。19份记录（22.9%）10%波幅递减为阴性但10%面积递减为阳性。3份记录（3.6%）10%波幅递减为阳性但10%面积递减为阴性。22例患者结果不一致。16份不一致的门诊病历（72.7%）可用于回顾专科医生的最终诊断。约69%的患者，其检查10%波幅递减为阴性但10%面积递减为阳性，被诊断为重症肌无力（MG）或疑似MG。所有检查10%面积递减为阴性但10%波幅递减为阳性的患者均被诊断为MG。使用10%波幅递减和10%面积递减而非仅使用10%波幅递减，在约13%的病例中可提供额外的诊断收益。
23%的患者RNS结果不一致，即10%波幅递减为阴性但10%面积递减为阳性。将这些不一致的结果与专科医生的最终诊断进行比较时，69%的此类患者被诊断或疑似为MG并接受相应治疗。使用10%波幅递减和10%面积递减可能会使约13%病例中MG诊断的敏感性提高。
