Pasnoor Mamatha, Dimachkie Mazen M, Farmakidis Constantine, Barohn Richard J
Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA.
Department of Neurology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mail Stop 2012, Kansas City, KS 66160, USA.
Neurol Clin. 2018 May;36(2):261-274. doi: 10.1016/j.ncl.2018.01.010.
Myasthenia gravis (MG) diagnosis is primarily clinically based. By the end of the clinical evaluation, clinicians have a sense as to whether presenting symptoms and elicited signs are weakly or strongly supportive of MG. Diagnostic tests can reaffirm the clinicians' impression. Edrophonium testing is rarely used but helpful in cases of measurable ptosis. Decremental response on slow-frequency repetitive nerve stimulation has a modest diagnostic yield in ocular MG but is helpful in generalized MG cases. The most sensitive test is single-fiber electromyography. In this article, the authors review the diagnostic testing approach of practicing clinicians for suspected MG cases.
重症肌无力（MG）的诊断主要基于临床。在临床评估结束时，临床医生能够判断出现的症状和引出的体征对MG的支持程度是弱还是强。诊断测试可以再次确认临床医生的判断。依酚氯铵试验很少使用，但对可测量的上睑下垂病例有帮助。低频重复神经刺激时的递减反应在眼肌型MG中的诊断价值一般，但对全身型MG病例有帮助。最敏感的测试是单纤维肌电图。在本文中，作者回顾了执业临床医生对疑似MG病例的诊断测试方法。
