Myasthenia Gravis: The Daily PANCE Blueprint

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Myasthenia Gravis: The Daily PANCE Blueprint

A 45-year-old woman reports fluctuating ptosis and diplopia that worsen with prolonged activity and improve with rest. Strength testing shows fatigability, and the exam is otherwise normal. Which diagnostic study is most specific for confirming myasthenia gravis?

A. Tensilon test
B. EMG decrement
C. MRI brain
D. AChE level
E. ESR

Answer and topic summary

The answer is B. EMG decrement

Repetitive nerve stimulation EMG showing a decremental response is the most specific electrophysiologic finding for MG. Single-fiber EMG (not listed) is the most sensitive, but for poll clarity, EMG decrement is the correct answer.

  • Tensilon test – Helpful screening tool; false positives occur.
  • MRI brain – No role; MG is a neuromuscular junction disorder.
  • AChE level – Not a diagnostic study in MG.
  • ESR – Nonspecific inflammation marker.
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Covered under ⇒ PANCE Blueprint Neurology ⇒ Neuromuscular disorders ⇒ Myasthenia gravis

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