Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Department of Neurology, Stanford University Hospital, Palo Alto, California, USA.
Muscle Nerve. 2021 Sep;64(3):270-276. doi: 10.1002/mus.27260. Epub 2021 Jul 7.
INTRODUCTION/AIMS: Telemedicine may be particularly well-suited for myasthenia gravis (MG) due to the disorder's need for specialized care, its hallmark fluctuating muscle weakness, and the potential for increased risk of virus exposure among patients with MG during the coronavirus disease 2019 (COVID-19) pandemic during in-person clinical visits. A disease-specific telemedicine physical examination to reflect myasthenic weakness does not currently exist.
This paper outlines step-by-step guidance on the fundamentals of a telemedicine assessment for MG. The Myasthenia Gravis Core Exam (MG-CE) is introduced as a MG-specific, telemedicine, physical examination, which contains eight components (ptosis, diplopia, facial strength, bulbar strength, dysarthria, single breath count, arm strength, and sit to stand) and takes approximately 10 minutes to complete.
Pre-visit preparation, remote ascertainment of patient-reported outcome scales and visit documentation are also addressed.
Additional knowledge gaps in telemedicine specific to MG care are identified for future investigation.
简介/目的：远程医疗特别适用于重症肌无力（MG），因为该病需要专业护理，其标志性的波动性肌肉无力，以及在 COVID-19 大流行期间MG 患者在面对面临床就诊期间因病毒暴露而增加的潜在风险。目前还没有专门用于反映肌无力的特定于 MG 的远程医疗体检。
本文概述了针对 MG 的远程医疗评估的基本步骤指南。引入了重症肌无力核心检查（MG-CE），作为一种特定于 MG 的远程医疗体检，它包含八个组成部分（上睑下垂、复视、面部力量、延髓力量、构音障碍、单呼吸计数、手臂力量和坐立位），大约需要 10 分钟完成。
还讨论了就诊前准备、远程确定患者报告的结果量表和就诊记录。
确定了 MG 护理中远程医疗特定的其他知识差距，以便进一步研究。
