用于重症肌无力诊断的重复神经刺激截断值。
Repetitive nerve stimulation cutoff values for the diagnosis of myasthenia gravis.
作者信息
Abraham Alon, Alabdali Majed, Alsulaiman Abdulla, Breiner Ari, Barnett Carolina, Katzberg Hans D, Lovblom Leif E, Bril Vera
机构信息
Ellen and Martin Prosserman Centre for Neuromuscular Diseases, Division of Neurology, Department of Medicine, University Health Network, Toronto General Hospital 200 Elizabeth Street, Room 5 EB 309, Toronto, Ontario, Canada, M5G 2C4.
Department of Neurology, King Fahad Hospital of the University, University of Dammam, Dammam, Saudi Arabia.
出版信息
Muscle Nerve. 2017 Feb;55(2):166-170. doi: 10.1002/mus.25214. Epub 2016 Nov 16.
INTRODUCTION
Repetitive nerve stimulation (RNS) showing ≥ 10% decrement is considered the cutoff for myasthenia gravis (MG), but this has never been validated. The objective of this study was to find an optimal validated cutoff value for decrement on RNS.
METHODS
We performed retrospective chart review of patients who had electrophysiological assessment for possible MG from 2013 to 2015.
RESULTS
A total of 122 patients with MG and 182 controls were identified. RNS sensitivities for generalized and ocular MG using the traditional ≥10% cutoff value were 46% and 15%, respectively, for frontalis recordings, and 35% and 19%, respectively, for nasalis recordings. Using a decrement cutoff value of 7% for frontalis and 8% for nasalis increased the sensitivities by 6-11%, with specificities of 95-96%.
CONCLUSIONS
For RNS in facial muscles, we suggest a cutoff value of 7-8%, which increases test sensitivity by 6-11%, while preserving high specificity for the diagnosis of MG. Muscle Nerve, 2016 Muscle Nerve 55: 166-170, 2017.
引言
重复神经电刺激（RNS）显示递减幅度≥10%被认为是重症肌无力（MG）的诊断标准，但这从未得到验证。本研究的目的是找到一个经过验证的RNS递减幅度的最佳临界值。
方法
我们对2013年至2015年因可能患有MG而接受电生理评估的患者进行了回顾性病历审查。
结果
共确定了122例MG患者和182例对照。使用传统的≥10%临界值，额肌记录时，全身型和眼肌型MG的RNS敏感性分别为46%和15%，鼻肌记录时分别为35%和19%。将额肌递减临界值设为7%，鼻肌设为8%，敏感性提高了6 - 11%，特异性为95 - 96%。
结论
对于面部肌肉的RNS，我们建议临界值为7 - 8%，这可使检测敏感性提高6 - 11%，同时保持对MG诊断的高特异性。《肌肉与神经》，2016年 《肌肉与神经》55: 166 - 170, 2017年。
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