Differential Response to Corticosteroids in Immune-Mediated Myokymia vs Grouped Fasciculation Discharges.

IF 1.8 4区医学 Q3 CLINICAL NEUROLOGY

Annals of Indian Academy of Neurology Pub Date : 2025-09-03 DOI:10.4103/aian.aian_76_25

Rithvik Ramesh, Sundar Shanmugam, Philo Hazeena, Lakshmi Narasimhan Ranganathan, Deepa Avadhani

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引用次数: 0

Abstract

Abstract: Myokymia and grouped fasciculation discharges (GFD) are electromyographic manifestations of peripheral nerve hyperexcitability syndromes. This case series explores the differential response to corticosteroids in patients with myokymia compared to those with GFDs. Six patients were included in this report: three with predominant myokymia and three with predominant GFDs, reviewed between March 2023 and February 2024. Electromyographic examinations were performed on various muscle groups, with the gastrocnemius EMG findings serving as an index. The neurologist conducting the EMG was blinded to the clinical history. Patients with predominant myokymia showed a positive response to corticosteroids. In contrast, patients with GFDs, characterized by non-rhythmic, irregular discharges, exhibited a limited response requiring higher immunotherapy. This study potentially highlights the importance of EMG in guiding treatment decisions, demonstrating that patients with myokymia respond well to corticosteroids due to underlying autoantibody-mediated potassium channel dysfunction.

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免疫介导的肌萎缩症与组束状放电对皮质类固醇的差异反应。

摘要：肌无力和成组束状放电（GFD）是周围神经高兴奋性综合征的肌电图表现。本病例系列探讨了肌萎缩症患者与GFDs患者对皮质类固醇的不同反应。本报告纳入了6例患者：3例患有明显的肌无力，3例患有明显的GFDs，回顾时间为2023年3月至2024年2月。以腓肠肌肌电图为指标，对各肌群进行肌电图检查。进行肌电图的神经科医生对患者的临床病史一无所知。以肌萎缩症为主的患者对皮质类固醇有积极反应。相比之下，以非节律性、不规则放电为特征的GFDs患者表现出有限的反应，需要更高的免疫治疗。这项研究潜在地强调了肌电图在指导治疗决策中的重要性，表明由于潜在的自身抗体介导的钾通道功能障碍，肌萎缩症患者对皮质类固醇反应良好。

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

Annals of Indian Academy of Neurology Nervous System Diseases-

CiteScore

2.20

自引率

11.80%

发文量

293

审稿时长

29 weeks

期刊介绍： The journal has a clinical foundation and has been utilized most by clinical neurologists for improving the practice of neurology. While the focus is on neurology in India, the journal publishes manuscripts of high value from all parts of the world. Journal publishes reviews of various types, original articles, short communications, interesting images and case reports. The journal respects the scientific submission of its authors and believes in following an expeditious double-blind peer review process and endeavors to complete the review process within scheduled time frame. A significant effort from the author and the journal perhaps enables to strike an equilibrium to meet the professional expectations of the peers in the world of scientific publication. AIAN believes in safeguarding the privacy rights of human subjects. In order to comply with it, the journal instructs all authors when uploading the manuscript to also add the ethical clearance (human/animals)/ informed consent of subject in the manuscript. This applies to the study/case report that involves animal/human subjects/human specimens e.g. extracted tooth part/soft tissue for biopsy/in vitro analysis.