Repetitive stimulation of the anconeal muscle

This video is in Dutch. It contains a demonstration of repetitive nerve stimulation, recorded from the anconeal muscle. Repetitive nerve stimulation is a technique to diagnose diseases of the neuromuscular junction, of which myasthenia gravis is the most common. The anconeal muscle is not commonly investigated, but I find it a particularly useful muscle for three reasons: 1) the investigation is quick and easy, 2) its diagnostic yield is surprisingly high and 3) it is well tolerated. Nonetheless, for a proper investigation, make sure to include several muscles, and if possible, investigate muscles that are clinically weak.

[@AbdelkaderBenichou-uf5kq]

Thank you , great job

[@krmztrk818]

thanks for your demostration.

[@gamaltaher9714]

Thanks, but what about post-exercise RNS with this muscle?

[@leidenclinicalneurophysiology]

Hi, I usually don't do post-exercise RNS, but it is a matter of taste. It could lead to a slight increase in diagnostic yield, but I prefer to use my time to investigate multiple muscles, which also increases diagnostic yield.

[@gamaltaher9714]

@@leidenclinicalneurophysiology which other muscles do you prefer ? Other than clinically affected muscles.

[@leidenclinicalneurophysiology]

@@gamaltaher9714 We usually go for abductor digiti minimi, anconeus, nasalis and trapezius. I recently learned that the deltoid also has a relatively high sensitivity for MG.

[@gamaltaher9714]

@@leidenclinicalneurophysiology Thanks, what is your protocol to confirm that the decrement is due to MG and not due to chronic neurogenic conditions as MND

[@clairee7598]

🤭 kennelijk heb ik altijd de klemtoon verkeerd gelegd. Ik dacht m. ancóneus was..

[@leidenclinicalneurophysiology]

Eerlijk gezegd heb ik geen idee Claire! Ik heb een tijdje geleden aan de neuroanatoom van het LUMC gevraagd wat de juiste uitspraak was, maar hij wist het ook niet. Ik doe dus maar wat :)