Ocular Myasthenia Gravis: clinical-instrumental assessment and the contribute of SFEMG

L. Padua, M. Lomonaco, A. Evoli, A. Batocchi, B. Gregori, P. Tonali

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Gold standard tests are not available in Ocular Myasthenia Gravis (OMG) diagnosis. Extreme heterogeneity of diagnostic criteria are reported in literature. Many diagnostic instrumental and pharmacological tests are used but none of these contemporary display a good sensitivity and specificity. SFEMG is considered the more sensitive test, but it has not a high specificity. In this study complete clinical-instrumental assessment of 86 suspected OMG was made using strict diagnostic criteria: abnormal findings at neurophysiological evaluation (low-rate repetitive nerve stimulation and SFEMG were always performed), response to anticholynesterase administration, positive antiacetylcholine receptor antibody (AChR-ab) titres. Patients were considered affected by OMG when fulfilling at least two of three criteria. OMG was diagnosed in 40% of patients, other disease were diagnosed (through other instrumental evaluations) in 10%. Our data confirm the high sensitivity of SFEMG but also the risk false-positive (2/86). The use of diagnostic criteria and the increase of SF-EMG cut-off preserve from the risk of misdiagnosing OMG. Moreover SFEMG appeared to be predicting tool, in fact the patients with marked abnormal SFEMG findings have developed a generalised MG. Our data, confirm, the high percentage of undiagnosed patient (50%) with ocular symptoms.

Original languageEnglish
Pages (from-to)101
Number of pages1
JournalItalian Journal of Neurological Sciences
Issue number4
Publication statusPublished - 1997

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology


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