2021 Workshop Handout Bundle-EDX Evaluation of Neuromuscular Junction (NMJ) Transmission Disorder

EDX Evaluation of Neuromuscular Junction (NMJ) Transmission Disorder - Laughin

Pdf Summary

This document discusses the EDX evaluation of neuromuscular junction transmission disorders, focusing on the relationship between compound muscle action potentials (CMAP) and the safety factor of neuromuscular transmission (SFNMT). It explains the process of CMAP neurophysiology, including the stimulation of a motor nerve and the propagation of action potentials down the nerve. It also describes the release of acetylcholine at the synapse and its binding to Ach receptors on the muscle endplate, leading to muscle fiber activation. The document further explains that the difference between the nerve action potential and the threshold for muscle fiber activation represents the SFNMT.<br /><br />The document also discusses the effects of repetitive nerve stimulation (RNS) on the SFNMT. It explains that slow rates of RNS can result in a decrement in the end-plate potential, while rapid RNS or brief exercise can increase the end-plate potential and improve neuromuscular transmission. The criteria for abnormality in RNS testing are also outlined, including a decrement of at least 10% between first and last responses in the train, reproducible results, and a consistent pattern of decrement.<br /><br />The document mentions the pitfalls of RNS testing, such as poor technique, inappropriate medications or surgery, and potential delays in successful treatment. It emphasizes the importance of careful technique, patient positioning, and thorough testing.<br /><br />Overall, this document provides an overview of the EDX evaluation of neuromuscular junction transmission disorders, specifically focusing on CMAP neurophysiology and the effects of repetitive nerve stimulation.

Keywords

EDX evaluation

neuromuscular junction transmission disorders

compound muscle action potentials

safety factor of neuromuscular transmission

CMAP neurophysiology

repetitive nerve stimulation

end-plate potential

abnormality in RNS testing

pitfalls of RNS testing

thorough testing