The difficulty in confirming clinical diagnosis of Myasthenia Gravis in a seronegative patient: a possible neurophysiological approach

Amelia Evoli, Luca Padua, Pietro Caliandro, Giuseppe Granata, Pietro Attilio Tonali, E. Stålberg

Risultato della ricerca: Contributo in rivistaArticolo in rivista

3 Citazioni (Scopus)


In seronegative myasthenia gravis repetitive nerve stimulation and single-fibre EMG have a crucial diagnostic value but they may be negative, particularly in repetitive nerve stimulation studies. We report the case of a 43-year-old patient with generalized seronegative myasthenia gravis with negative 3 Hz repetitive nerve stimulation at Erb's point and voluntary single-fibre EMG in the orbicularis oculi. We also performed 6 and 12 Hz repetitive nerve stimulation at Erb and stimulated single-fibre EMG in the extensor digitorum communis and our findings were pathological. Our data suggest that, for individual patients with an atypical picture characterised by dissociation between a severe clinical pattern and no definite neurophysiological findings on conventional tests, repetitive nerve stimulation with a stimulation rate higher than 3 Hz and/or stimulated single-fibre EMG with an increasing stimulation rate may be helpful.
Lingua originaleEnglish
pagine (da-a)825-827
Numero di pagine3
RivistaJournal of Clinical Neuromuscular Disease
Stato di pubblicazionePubblicato - 2009


  • Myasthenia gravis
  • Repetitive nerve stimulation
  • Single fibre

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