神经电生理检查判断眼肌型重症肌无力的敏感度分析

目的：分析眼肌型重症肌无力（OMG）患者的神经电生理特点,为临床诊断提供有价值的依据.方法：对42例临床诊断为OMG患者进行单纤维肌电图、重复神经电刺激和肌电图检测.结果：伸指总肌的单纤维肌电图34例异常,重复电刺激异常23例;肌电图示14例肌源性损害.结论：OMG患者单纤维肌电图是一种敏感度较高的检测方法,其次为重复神经电刺激,其肌肉检测阳性率高低依次为眼轮匝肌、肱二头肌及小指展肌.

The Sensitivity Analysis of Electrophysiologic Examination for Ocular Myasthenia Gravis

Aim： To compare the sensitivity of different electrophysiologic examinations, electromyograph （EMG）, single fiber EMG （SFEMG） and repeating nerve electric stimulation（RNS） in the diagnosis for ocular myasthenia gravis （OMG）. Methods： EMG, SFEMG and RNS were performed in 42 patients clinically diagnosed as OMG. Results： SFEMG revealed increased Jitter in 34 patients（80.9%）. RNS showed abnormality of the minimal digital abductor in 8 patients（19.1%）, of the biceps in 20 patients（47.6%） and orbicularis oculi in 23 patients （54.7%）. Meanwhile, routine EMG presented musclular lesions in only 14 patients（33.3%）, and normal in the other patients. Conclusion： Among the electrophysiologic examinations, SFEMG is a method with the highest sensitivity, followed by RNS in ocular orbicular muscle, biceps and minimal digital abductor. These findings suggest that the combination of the above electrophysiologic examinations, rather than any single method, would be more helpful for the diagnosis of OMG.