Peroneal nerve repetitive nerve stimulation test: its value in diagnosis of myasthenia gravis and Lambert–Eaton myasthenic syndrome

SJ Oh, T Head, J Fesenmeier… - Muscle & Nerve: Official …, 1995 - Wiley Online Library
SJ Oh, T Head, J Fesenmeier, G Claussen
Muscle & Nerve: Official Journal of the American Association of …, 1995Wiley Online Library
We have developed a repetitive nerve stimulation (RNS) technique for the peroneal nerve.
Normal limits for the decremental responses for the anterior tibialis and extensor digitorum
brevis muscles are 6–21% at the low rate of stimulation and 44–70% at the high rate of
stimulation. These values exceed the normal limits for other commonly tested muscles. This
may be due to the lower safety factor for neuromuscular transmission for the anterior tibialis
and extensor digitorum brevis muscles. We present 4 cases in which the peroneal nerve …
Abstract
We have developed a repetitive nerve stimulation (RNS) technique for the peroneal nerve. Normal limits for the decremental responses for the anterior tibialis and extensor digitorum brevis muscles are 6–21% at the low rate of stimulation and 44–70% at the high rate of stimulation. These values exceed the normal limits for other commonly tested muscles. This may be due to the lower safety factor for neuromuscular transmission for the anterior tibialis and extensor digitorum brevis muscles. We present 4 cases in which the peroneal nerve RNS test was crucial for the diagnosis of the limb‐girdle form of MG or LEMS. Thus, we conclude that, in a small number of patients with neuromuscular transmission disorders, the peroneal nerve RNS test is needed for confirmation of disease. © 1995 John Wiley & Sons, Inc.
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