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Single Fiber EMG as an Outcome Measure in Myasthenia Gravis: Results from a Double-Blind, Placebo-Controlled Trial

Meriggioli, Matthew N.; Rowin, Julie


Summary In a placebo-controlled, therapeutic, pilot trial of mycophenolate mofetil (MM) in autoimmune myasthenia gravis (MG), the authors compared pretreatment and posttreatment single fiber electromyography (SFEMG) jitter measurements performed on the same muscle in a total of 11 patients. The mean jitter value decreased (improved) by an average of 15.4 μs in patients receiving MM (n = 6), compared to an increase (worsening) in mean jitter of 4.0 μs in patients receiving placebo (n = 5). This difference was statistically significant (P = 0.030). In most patients, the change in SFEMG measurements correlated with the change in clinical state as measured by quantitative testing of muscle function. The authors conclude that immunomodulation by MM improves neuromuscular junction function in MG and that SFEMG may be a useful marker of early response in future therapeutic trials in autoimmune MG.

Department of Neurological Sciences, Rush University and Rush-Presbyterian-St. Luke’s Medical Center, Chicago, Illinois, U.S.A.

Address correspondence and reprint requests to Dr. Matthew N. Meriggioli, Rush University, Department of Neurological Sciences, 1725 W Harrison Street, Suite 1106, Chicago, IL 60612 U.S.A.; e-mail:

Supported in part by Roche Pharmaceuticals Co. Grant CEL 132 and by a grant from the Myasthenia Gravis Foundation of Illinois.

Copyright © 2003 American Clinical Neurophysiology Society