Neuromuscular Disorders
Volume 19, Issue 12 , Pages 825-827 , December 2009

The difficulty in confirming clinical diagnosis of myasthenia gravis in a seronegative patient: A possible neurophysiological approach

  • P. Caliandro

      Affiliations

    • Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
    • Fondazioni Don Carlo Gnocchi ONLUS, Rome, Italy
    • Corresponding Author InformationCorresponding author. Address: Institute of Neurology, Largo F. Vito 1, 00168 Rome, Italy. Tel.: +39 06 30154435; fax: +39 06 35501909.
    • ,
  • A. Evoli

      Affiliations

    • Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
    • ,
  • E. Stålberg

      Affiliations

    • Department of Clinical Neurophysiology, University Hospital, Uppsala, Sweden
    • ,
  • G. Granata

      Affiliations

    • Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
    • ,
  • P. Tonali

      Affiliations

    • Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
    • Fondazioni Don Carlo Gnocchi ONLUS, Rome, Italy
    • ,
  • L. Padua

      Affiliations

    • Institute of Neurology, Catholic University of Sacred Heart, Rome, Italy
    • Fondazioni Don Carlo Gnocchi ONLUS, Rome, Italy

Received 12 May 2009 ,Revised 28 July 2009 ,Accepted 8 September 2009.

References 

  1. Hoch W, McConville J, Helms S, Newsom-Davis J, Melms A, Vincent A. Auto-antibodies to the receptor tyrosine kinase MuSK in patients with myasthenia gravis without acetylcholine receptor antibodies. Nat Med. 2001;7:365–368
  2. Padua L, Tonali P, Aprile I, Caliandro P, Bartoccioni E, Evoli A. Seronegative myasthenia gravis: comparison of neurophysiological picture in MuSK+ and MuSK patients. Eur J Neurol. 2006;13:273–276
  3. Evoli A, Tonali PA, Padua L, et al. Clinical correlates with anti-MuSK antibodies in generalized seronegative myasthenia gravis. Brain. 2003;126(Pt. 10):2304–2311
  4. Gilchrist JM. Ad hoc Committee: single fiber EMG reference values: a collaborative effort. Muscle Nerve. 1992;15:151–161
  5. Ukachoke C, Ashby P, Sharpe JA. Usefulness of single fiber EMG for distinguishing neuromuscular from other causes of ocular muscle weakness. Can J Neurol Sci. 1994;21:125–128
  6. Bromberg MB, Scott DM. Single fiber EMG reference values: reformatted in tabular form. AD HOC Committee of the AAEM Single Fiber Special Interest Group. Muscle Nerve. 1994;17:820–821
  7. Trontelj JV, Mihelin M, Fernandez JM, Stålberg E. Axonal stimulation for end-plate jitter studies. J Neurol Neurosurg Psychiatry. 1986;49:677–685
  8. Waud DR, Waud BE. In vitro measurement of margin of safety of neuromuscular transmission. Am J Physiol. 1975;229:1632–1634
  9. Trontelj JV, Stålberg E. Single motor end-plates in myasthenia gravis and LEMS at different firing rates. Muscle Nerve. 1990;14:226–232
  10. Valls-Canals J, Povedano M, Montero J, Pradas J. Stimulated single-fiber EMG of the frontalis and orbicularis oculi muscles in ocular myasthenia gravis. Muscle Nerve. 2003;28(4):501–503

PII: S0960-8966(09)00618-X

doi: 10.1016/j.nmd.2009.09.005

Neuromuscular Disorders
Volume 19, Issue 12 , Pages 825-827 , December 2009

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