Electrodiagnostic criteria for neuromuscular transmission disorders suggested by a European consensus group

IF 2 Q3 NEUROSCIENCES

Clinical Neurophysiology Practice Pub Date : 2025-01-01 DOI:10.1016/j.cnp.2025.02.011

H. Tankisi , K. Pugdahl , B. Johnsen , J.P. Camdessanché , M. de Carvalho , P. Fawcett , A. Labarre-Vila , R. Liguori , W. Nix , I. Schofield , A. Fuglsang-Frederiksen

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引用次数: 0

Abstract

Objective

Electrodiagnostic testing plays an important role in diagnosing disorders of neuromuscular transmission (NMT), especially in seronegative myasthenia gravis. However, electrodiagnostic criteria for the diagnosis are sparse. This study aimed at inferring evidence-based recommendations for the electrodiagnostic examination of NMT disorders.

Methods

A total of 164 cases with a consensus diagnosis of NMT disorder obtained by peer review by eight experienced neurophysiologists were analysed for differences in examination strategy, the sensitivity of different tests, and inferring minimal criteria. The diagnostic performance of the suggested criteria was validated on 24 MG patients and 50 patients with neuropathy (17), myopathy (15), or fatigue (18).

Results

We recommend as minimal electrodiagnostic criteria for NMT disorders, either (a) 2 abnormal repetitive nerve stimulation (RNS), (b) 1 abnormal RNS and 1 abnormal single fiber electromyography (SFEMG) or (c) 2 abnormal SFEMG. These showed a good diagnostic performance with a sensitivity of 87.5 % and a specificity of 100 %.

Conclusion

Recommendations with high diagnostic sensitivity and specificity for the minimum number of RNS and SFEMG studies to diagnose NMT disorders developed by an international consensus group are suggested.

Significance

The suggested electrodiagnostic recommendations for diagnosing NMT disorders are reliable and suitable for use at different centres.

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欧洲共识小组提出的神经肌肉传递障碍的电诊断标准

目的电诊断在诊断神经肌肉传递障碍（NMT），特别是血清阴性重症肌无力中具有重要意义。然而，诊断的电诊断标准是稀疏的。本研究旨在推断NMT疾病电诊断检查的循证建议。方法对经8位经验丰富的神经生理学家同行评议的164例一致诊断为NMT障碍的病例进行分析，分析其检查策略、不同检查方法的敏感性以及推断最小标准的差异。建议的诊断标准在24名MG患者和50名神经病变（17名）、肌病（15名）或疲劳（18名）患者中得到了验证。结果我们推荐NMT障碍的最低电诊断标准为：(a) 2个异常的重复神经刺激（RNS）， (b) 1个异常的重复神经刺激（RNS）和1个异常的单纤维肌电图（SFEMG）或(c) 2个异常的SFEMG。结果表明，该方法具有良好的诊断性能，敏感性为87.5%，特异性为100%。结论国际共识小组提出了诊断NMT疾病的高诊断敏感性和特异性的RNS和SFEMG研究的最少数量的建议。建议的诊断NMT疾病的电诊断建议是可靠的，适合在不同的中心使用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Neurophysiology Practice NEUROSCIENCES-

CiteScore

3.90

自引率

0.00%

发文量

审稿时长

71 days

期刊介绍： Clinical Neurophysiology Practice (CNP) is a new Open Access journal that focuses on clinical practice issues in clinical neurophysiology including relevant new research, case reports or clinical series, normal values and didactic reviews. It is an official journal of the International Federation of Clinical Neurophysiology and complements Clinical Neurophysiology which focuses on innovative research in the specialty. It has a role in supporting established clinical practice, and an educational role for trainees, technicians and practitioners.