Kouyoumdjian João Aris, Paiva Gabriel Pina, Stålberg Erik
Laboratório Investigação Neuromuscular, Faculdade Estadual Medicina São José do Rio Preto, São Paulo, Brazil.
Department of Clinical Neurophysiology, Institute of Neurosciences, Uppsala University, Uppsala, Sweden.
Front Neurol. 2020 Nov 13;11:600680. doi: 10.3389/fneur.2020.600680. eCollection 2020.
To estimate the jitter parameters (single-fiber electromyography) in myasthenia gravis patients mostly by electrical activation in , and muscles using a concentric needle electrode. Between 2009 and 2019, a total of 97 myasthenia gravis patients, 52 male, and mean age 54 years were included. Any abnormal jitter parameter in individual muscles was 90.5% (), 88.5% (), and 86.6% (). Any jitter parameter combining and muscle was abnormal in 100% for the ocular, and in 92.9% for the generalized myasthenia gravis. The most abnormal muscle was for the generalized, and for the ocular myasthenia gravis. The decrement was abnormal in 78.4%, 85.9% for the generalized, and 25% for the ocular myasthenia gravis. The mean jitter ranged from 14.2 to 86 μs (mean 33.3 μs) for the ocular myasthenia gravis and from 14.4 to 220.4 μs (mean 66.3 μs) for the generalized myasthenia gravis. The antibody titers tested positive in 86.6%, 91.8% for the generalized, and 50% for the ocular myasthenia gravis. Thymectomy was done in 48.5%, thymoma was found in 19.6%, and myasthenic crisis occurred by 21.6%. The jitter parameters achieved a 100% abnormality in ocular myasthenia gravis if both the and muscles were tested. There was a high jitter abnormality in generalized myasthenia gravis cases with one muscle tested, with about a 2% increase in sensitivity when a second is added. Concentric needle electrode jitter had high sensitivity similar to the single fiber electrode (93.8%), followed by antibody titers (86.6%), and abnormal decrement (78.4%).
主要通过使用同心针电极电刺激重症肌无力患者的[具体肌肉名称未给出]、[具体肌肉名称未给出]和[具体肌肉名称未给出]肌肉来评估其抖动参数（单纤维肌电图）。2009年至2019年期间，共纳入97例重症肌无力患者，其中男性52例，平均年龄54岁。单个肌肉中任何异常抖动参数在[具体肌肉名称未给出]肌肉中为90.5%，在[具体肌肉名称未给出]肌肉中为88.5%，在[具体肌肉名称未给出]肌肉中为86.6%。对于眼肌型重症肌无力，[具体肌肉名称未给出]和[具体肌肉名称未给出]肌肉联合的任何抖动参数异常率为100%；对于全身型重症肌无力，该联合异常率为92.9%。全身型重症肌无力中最异常的肌肉是[具体肌肉名称未给出]，眼肌型重症肌无力中最异常的肌肉是[具体肌肉名称未给出]。全身型重症肌无力的递减异常率为78.4%，眼肌型重症肌无力的递减异常率为85.9%，后者为25%。眼肌型重症肌无力的平均抖动范围为14.2至86微秒（平均33.3微秒），全身型重症肌无力的平均抖动范围为14.4至220.4微秒（平均66.3微秒）。全身型重症肌无力的抗体滴度阳性率为86.6%，眼肌型重症肌无力的抗体滴度阳性率为91.8%，后者为50%。48.5%的患者接受了胸腺切除术，19.6%的患者发现有胸腺瘤，21.6%的患者发生了肌无力危象。如果同时检测[具体肌肉名称未给出]和[具体肌肉名称未给出]肌肉，眼肌型重症肌无力的抖动参数异常率达到100%。在检测一块肌肉的全身型重症肌无力病例中，抖动异常率较高，增加检测第二块肌肉时敏感性约提高2%。同心针电极抖动的敏感性较高，与单纤维电极相似（93.8%），其次是抗体滴度（86.6%）和异常递减（78.4%）。
