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Electrophysiologic evaluation of myasthenia gravis and its mimics: real-world experience with single-fiber electromyography

Electrophysiologic evaluation of myasthenia gravis and its mimics: real-world experience with single-fiber electromyography

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https://www.tandfonline.com/doi/abs/10.1080/21548331.2022.2125706?journalCode=ihop20

ABSTRACT In centers which routinely perform single fiber electromyography (SFEMG) for suspected myasthenia gravis (MG), the additional benefit of other neurophysiologic investigations and the frequency of myasthenia mimics has not been ascertained. We aimed to illustrate the range of neurological and non-neurological myasthenia mimics referred for evaluation, and contrast features of their electrophysiologic evaluation with confirmed MG.


Conclusion: SFEMG can be abnormal in a number of myasthenia mimics, and routine nerve conduction studies and electromyography should always be undertaken. In centers where SFEMG is performed routinely for the investigation of suspected MG, extensive proximal repetitive nerve stimulation can be foregone without substantially affecting diagnostic evaluation. Normal SFEMG in those with confirmed myasthenia gravis may help indicate clinical remission.