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NCS-CMAP REPETITIVE STIMULATION STUDIES

Neurology

NCS-CMAP REPETITIVE STIMULATION STUDIES

1. In healthy individuals, the presynaptic terminal releases 3-5x as much Ach as is required to activate the postsynaptic membrane, termed safety factor.

2. Repetitive stimulation studies are primarily useful for detection of NMJ abnormalities in which the safety factor is diminished.

3. Motor units fire at 30Hz to activate muscle contraction, there is build-up of pre-synaptic Ca 2+ which facilitates the release of Ach, termed post-exercise facilitation.

4. Post-exercise exhaustion occurs 2-4 min after sustained exercise.

5. Used in diagnosis of MG, Lambert-Eaton myasthenic syndrome (LEMS), botulism. High specificity, 60%-70% sensitivity.


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REFERENCES

1. Wilkinson, I. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press.
2. Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
3. Image: no reference available.

Ⓒ A. Manickam 2018

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