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Investigations

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There is an established series of tests for diagnosing myasthenia gravis:

  • diagnosis can be confirmed by observing an improvement in strength after administering a short-acting anticholinesterase drug, for example, edrophonium chloride.
  • electromyography may reveal that repetitive supramaximal nerve stimulation at low frequencies (3Hz) causes an abnormal decrement of the compound muscle potential due to blocking of transmission to individual muscle fibres
  • in approximately 75% of patients with ocular symptoms, acetylcholine receptor antibodies are present. These are present in approximately 90% of patients with generalised disease
  • a mediastinal computerise tomographic or magnetic resonance scan is required to detect a thymoma

N.B. anti-striated muscle antibody is associated with an increased risk of thymoma.

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