Serial Stimulated Jitter Analysis In Juvenile Myasthenia Gravis

Muscle Nerve. 2018 Nov;58(5):729-732. doi: 10.1002/mus.26319. Epub 2018 Oct 2.

Abstract

Introduction: Clinical and electrophysiological studies to measures disease activity in juvenile myasthenia gravis (JMG) are limited.

Methods: Retrospective review of the clinical profile, Myasthenia Gravis Foundation of America (MGFA) scores, serial stimulated jitter analysis (Stim-JA) of the orbicularis oculi muscle, grip strength, and spirometry of patients with JMG who were followed in a multidisciplinary clinic was performed.

Results: Thirteen patients with JMG (9 females) with mean age of 13.2 ± 4.8 years and follow-up duration of 25.3 ± 8.3 months (range, 6-39) with ≥ 2 Stim-JA recordings were included. The mean jitter, mean percentage of apparent single-fiber action potentials (%ASFAP) with increased jitter, and mean %ASFAP with blocking at baseline values (77.3 ± 54.7 µs, 64.3% ± 35.8%, 39% ± 38.6%, respectively) and at follow-up (53 ± 45.4 µs, 51.2% ± 34.5%, 17% ± 29.4%, respectively) were abnormal; however, no statistically significant interval difference was noted. The electrophysiological data correlated significantly with Myasthenia Gravis Foundation of America (MGFA) class. Grip strength and spirometry did not correlate with MGFA class.

Discussion: Stimulated jitter values are sensitive biomarkers in JMG. Muscle Nerve 58: 729-732, 2018.

Keywords: MGFA class; biomarkers; forced vital capacity; grip strength; juvenile myasthenia gravis; serial jitter; single-fiber EMG.

MeSH terms

  • Action Potentials / physiology
  • Adolescent
  • Child
  • Child, Preschool
  • Electromyography
  • Facial Muscles / physiopathology
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Muscle Strength / physiology*
  • Myasthenia Gravis / diagnosis*
  • Myasthenia Gravis / physiopathology*
  • Retrospective Studies
  • Spirometry
  • Vital Capacity
  • Young Adult