AAEE Minimonograph #33: electrodiagnostic approach to defects of neuromuscular transmission.

Clinical testing for neuromuscular dysfunction is supported by an extensive amount of excellent basic information about normal and abnormal subcellular physiology and ultrastructure. This information provides an essential frame of reference for describing the rationale of single-fiber electromyography (SFEMG). SFEMG in turn helps to explain the more conventional clinical testing of neuromuscular function by repetitive nerve stimulation (RNS). Electrical findings in myasthenia gravis, Lambert-Eaton myasthenic syndrome, and botulinum intoxication are discussed from the subcellular level via the cellular level (SFEMG) to the integrated responses of whole muscle (RNS) as a rational means of understanding the technique of clinical repetitive nerve stimulation.