Effect of exercise on repetitive nerve stimulation studies: new appraisal of an old technique.
Repetitive nerve stimulation (RNS) is a simple and rapid method for evaluation of neuromuscular transmission defects. Although the effect of exercise in conjunction with RNS is well recognized, it has not been standardized in actual patient and control groups. In a prospective study over a period of 1 year, the authors evaluated the effect of exercise in conjunction with RNS in comparison with conventional 3-Hz RNS at rest in the clinical setting. Fifty-four patients who were referred for possible neuromuscular transmission disorders, in addition to 35 healthy control subjects, were studied. Amplitude and area decremental responses with RNS at rest and after 20 seconds of maximal exercise at 1-minute intervals up to 3 minutes were evaluated. The use of RNS with exercise resulted in additional diagnostic yield of up to 36.4% compared with conventional 3-Hz RNS at rest. The standardized use of exercise with RNS is advocated for increasing its diagnostic yield in the neurophysiologic laboratory.
Lo
Yew-Long
YL
Department of Neurology, National Neuroscience Institute, Singapore General Hospital, Singapore. gnrlyl@sgh.com.sg
Dan
Yang-Fang
YF
Leoh
Teng-Hee
TH
Tan
Yam-Eng
YE
Nurjannah
Siti
S
Ratnagopal
Pavanni
P
D000328:Adult; D000368:Aged; D004558:Electric Stimulation / Q000379:methods*; D004576:Electromyography / Q000379:methods*; D005080:Exercise Test / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis*; D020511:Neuromuscular Junction Diseases / Q000175:diagnosis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity