Repetitive nerve stimulation for the evaluation of peripheral nerve hyperexcitability

Michael G Benatar, Kristine M. Chapman, Seward B. Rutkove

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

Objective: To examine the utility of repetitive nerve stimulation (RNS) in the evaluation of peripheral nerve hyperexcitability (PNH). Background: PNH describes a group of disorders characterized by muscle cramps, twitching and stiffness. When severe, PNH may be characterized by the presence of continuous muscle fiber activity on routine needle electromyography (EMG). In milder forms of the disease, nerve hyperexcitability may be evidenced by the presence of after-discharges or cramp potentials following RNS. Methods: Fifty-four patients were prospectively recruited and classified into one of three groups - PNH, other neuromuscular disease and controls. We recorded and quantified the after-discharges and cramp potentials following RNS at 1, 5, 10 and 30 Hz. Results: The proportion of nerves with after-discharges and/or cramp potentials was significantly greater in the PNH group than the control group at both 5 Hz (p=0.03) and 10 Hz (p=0.01), as well as in the neuromuscular disease group compared to controls at 5 Hz (p=0.02). There was also a significant concordance between complaints of muscle cramps and fasciculations and the finding of after-discharges and/or cramp potentials at both 5 Hz (p=0.005) and 10 Hz (p=0.004). At a stimulation frequency of 10 Hz, the sensitivity of RNS for the diagnosis of PNH (primary or secondary) was 79% and the specificity was 88%. Conclusion: Our findings suggest that RNS at or below a stimulation frequency of 10 Hz (when positive) is a useful test for the diagnosis of PNH, whether it is primary or secondary.

Original languageEnglish
Pages (from-to)47-52
Number of pages6
JournalJournal of the Neurological Sciences
Volume221
Issue number1-2
DOIs
StatePublished - Jun 15 2004
Externally publishedYes

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Muscle Cramp
Peripheral Nerves
Neuromuscular Diseases
Fasciculation
Electromyography
Needles
Muscles
Control Groups

Keywords

  • Fasciculation
  • Muscle cramp
  • Neurophysiology

ASJC Scopus subject areas

  • Aging
  • Clinical Neurology
  • Surgery
  • Developmental Neuroscience
  • Neurology
  • Neuroscience(all)

Cite this

Repetitive nerve stimulation for the evaluation of peripheral nerve hyperexcitability. / Benatar, Michael G; Chapman, Kristine M.; Rutkove, Seward B.

In: Journal of the Neurological Sciences, Vol. 221, No. 1-2, 15.06.2004, p. 47-52.

Research output: Contribution to journalArticle

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