Hi! Thank you for informative videos! I have ptosis in my right eyelid and both eyebrows, and double vision. Negative blood tests, positive ice test. The sfemg was done by someone who had not done this many times before, and analyzed with a more skilled doctor. In the frontalis they found 3 pairs out of 20 with abnormally high jitter, but the third was described as uncertain (they were not sure if it was a technical mistake), the next day they took 18 pairs of a muscle under the right eye (where I have no symptoms) and they were all normal. So, they said that with all the 38 pairs from both frontalis and under the eye, it was a total of under 10% abnormalities, and therefore normal findings. Is this correct?
Thanks for your question. This technique requires training and a good technical skill, and in borderline findings, I should be very careful in judgments. I have a few comments: 1. If your clinical conditions allow, before treatment, repeat the study after 1-3 months. 2.The study should be made in weak muscles (abnormalities may be seen in one muscle, not in others) 3. Final diagnosis is always clinical (supported by the test you indicate). From your descriptions, it really sounds like myasthenia, but this is up to your physician.
@@jittertube Thank you very much for your answer! I have a new test in three months. But I wonder, if it’s above 10% abnormalities in one muscle, if I for example get three certain abnormals out of twenty pairs (15%) in frontalis, but 0% abnormalities in another muscle, is the whole test normal then? Or is the test abnormal if only one muscle is above 10%, regardless of the other muscles? At my hospital they said that it is the total percentage of all pairs from both tested muscles that count. But I found that a bit strange?
The distribution of myasthenic abnormalities is unevenly disturbed among muscles. Frontalis may be normal on one side, normal on the other and so on. So, the judgement is: if one muscle is abnormal (definitely. i.e. > 2 out of 20 recordings), the study is abnormal. We do not make statistics of all recordings performed since some normal muscles may make the total study normal if one use %. I do not use percent, but > 2 out of 20 (voluntary activation). Note 3 out of 10 is abnormal. 2 out of 8 is 25% but not abnormal since it is not > 2
@@jittertube I contacted the hospital and luckily it was just a writing error in my case summary and miscommunication between the technician and my physician. But I will try to get my next sfemg at a bigger hospital with MG specialists. Thank you very much for your time and your advices!
This was really helpful, thank you!
Hello it was very useful thanks a lot.
Nice to hear. Stålberg
Hi! Thank you for informative videos! I have ptosis in my right eyelid and both eyebrows, and double vision. Negative blood tests, positive ice test. The sfemg was done by someone who had not done this many times before, and analyzed with a more skilled doctor.
In the frontalis they found 3 pairs out of 20 with abnormally high jitter, but the third was described as uncertain (they were not sure if it was a technical mistake), the next day they took 18 pairs of a muscle under the right eye (where I have no symptoms) and they were all normal.
So, they said that with all the 38 pairs from both frontalis and under the eye, it was a total of under 10% abnormalities, and therefore normal findings. Is this correct?
Thanks for your question. This technique requires training and a good technical skill, and in borderline findings, I should be very careful in judgments.
I have a few comments:
1. If your clinical conditions allow, before treatment, repeat the study after 1-3 months.
2.The study should be made in weak muscles (abnormalities may be seen in one muscle, not in others)
3. Final diagnosis is always clinical (supported by the test you indicate). From your descriptions, it really sounds like myasthenia, but this is up to your physician.
@@jittertube Thank you very much for your answer! I have a new test in three months. But I wonder, if it’s above 10% abnormalities in one muscle, if I for example get three certain abnormals out of twenty pairs (15%) in frontalis, but 0% abnormalities in another muscle, is the whole test normal then? Or is the test abnormal if only one muscle is above 10%, regardless of the other muscles? At my hospital they said that it is the total percentage of all pairs from both tested muscles that count. But I found that a bit strange?
The distribution of myasthenic abnormalities is unevenly disturbed among muscles. Frontalis may be normal on one side, normal on the other and so on.
So, the judgement is: if one muscle is abnormal (definitely. i.e. > 2 out of 20 recordings), the study is abnormal. We do not make statistics of all recordings performed since some normal muscles may make the total study normal if one use %. I do not use percent, but > 2 out of 20 (voluntary activation). Note 3 out of 10 is abnormal. 2 out of 8 is 25% but not abnormal since it is not > 2
@@jittertube I contacted the hospital and luckily it was just a writing error in my case summary and miscommunication between the technician and my physician. But I will try to get my next sfemg at a bigger hospital with MG specialists. Thank you very much for your time and your advices!