PMID- 24332471
OWN - NLM
STAT- MEDLINE
DCOM- 20150413
LR  - 20181202
IS  - 1872-8952 (Electronic)
IS  - 1388-2457 (Linking)
VI  - 125
IP  - 6
DP  - 2014 Jun
TI  - Is the decremental pattern in Lambert-Eaton syndrome different from that in 
      myasthenia gravis?
PG  - 1274-7
LID - S1388-2457(13)01178-4 [pii]
LID - 10.1016/j.clinph.2013.11.007 [doi]
AB  - OBJECTIVE: We reviewed our experience to determine if the decremental pattern 
      during low frequency repetitive nerve stimulation (LF-RNS) distinguishes between 
      the Lambert-Eaton myasthenic syndrome (LEMS) and myasthenia gravis (MG). METHODS: 
      LF-RNS studies were reviewed from 34 LEMS and 44 MG patients, 4 of whom had 
      antibodies to muscle specific kinase (MuSK). In each train we calculated the 
      ratio between the early and the later decrement. Receiver-operator characteristic 
      curves were calculated to determine the ratio that best distinguished between 
      LEMS and MG. RESULTS: The late decrement was more often greater in LEMS and the 
      converse was true in MG, but with some overlap in values in individual patients. 
      A late decrement more than 102% of the early decrement discriminated between LEMS 
      and MG in 90% of studies. The decremental pattern in MG patients with MuSK 
      antibodies resembled that in LEMS. CONCLUSION: When the decrement becomes 
      progressively greater during low frequency RNS, the patient is more likely to 
      have LEMS than MG, and in MG, is more likely to have MuSK antibodies. 
      SIGNIFICANCE: A progressive decrement in patients otherwise felt to have MG 
      should prompt further clinical, serological and electrodiagnostic tests. Further 
      studies are needed to assess the decremental pattern in MuSK MG.
CI  - Copyright (c) 2013 International Federation of Clinical Neurophysiology. Published 
      by Elsevier Ireland Ltd. All rights reserved.
FAU - Sanders, D B
AU  - Sanders DB
AD  - Neuromuscular Division, Department of Neurology, Duke University Medical Center, 
      Durham, NC, USA. Electronic address: Donald.Sanders@Duke.edu.
FAU - Cao, L
AU  - Cao L
AD  - Neuromuscular Division, Department of Neurology, Duke University Medical Center, 
      Durham, NC, USA.
FAU - Massey, J M
AU  - Massey JM
AD  - Neuromuscular Division, Department of Neurology, Duke University Medical Center, 
      Durham, NC, USA.
FAU - Juel, V C
AU  - Juel VC
AD  - Neuromuscular Division, Department of Neurology, Duke University Medical Center, 
      Durham, NC, USA.
FAU - Hobson-Webb, L
AU  - Hobson-Webb L
AD  - Neuromuscular Division, Department of Neurology, Duke University Medical Center, 
      Durham, NC, USA.
FAU - Guptill, J T
AU  - Guptill JT
AD  - Neuromuscular Division, Department of Neurology, Duke University Medical Center, 
      Durham, NC, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
DEP - 20131116
PL  - Netherlands
TA  - Clin Neurophysiol
JT  - Clinical neurophysiology : official journal of the International Federation of 
      Clinical Neurophysiology
JID - 100883319
SB  - IM
MH  - Diagnosis, Differential
MH  - Electric Stimulation
MH  - *Electrodiagnosis
MH  - Electromyography
MH  - Humans
MH  - Lambert-Eaton Myasthenic Syndrome/*diagnosis/physiopathology
MH  - Muscle, Skeletal/physiopathology
MH  - Myasthenia Gravis/*diagnosis/physiopathology
MH  - ROC Curve
OTO - NOTNLM
OT  - Clinical neurophysiology
OT  - Decrement
OT  - EMG
OT  - Lambert-Eaton syndrome
OT  - Myasthenia gravis
OT  - Neuromuscular transmission
OT  - Repetitive nerve stimulation
EDAT- 2013/12/18 06:00
MHDA- 2015/04/14 06:00
CRDT- 2013/12/17 06:00
PHST- 2013/08/19 00:00 [received]
PHST- 2013/11/10 00:00 [revised]
PHST- 2013/11/11 00:00 [accepted]
PHST- 2013/12/17 06:00 [entrez]
PHST- 2013/12/18 06:00 [pubmed]
PHST- 2015/04/14 06:00 [medline]
AID - S1388-2457(13)01178-4 [pii]
AID - 10.1016/j.clinph.2013.11.007 [doi]
PST - ppublish
SO  - Clin Neurophysiol. 2014 Jun;125(6):1274-7. doi: 10.1016/j.clinph.2013.11.007. 
      Epub 2013 Nov 16.