ĐÁNH GIÁ VAI TRÒ CỦA ĐIỆN CƠ SỢI ĐƠN TRONG CHẨN ĐOÁN BỆNH NHƯỢC CƠ TẠI BỆNH VIỆN NHÂN DÂN 115

Abstract

Objective: To develop a single-fiber electromyography (SFEMG) protocol for diagnosing myasthenia gravis at People's Hospital 115, based on international recommendations, and to evaluate the feasibility, effectiveness, and safety of the protocol in clinical practice. Subjects and Methods: We conducted a prospective case series including five patients who had clinical suspicion of myasthenia gravis and negative results on 3Hz repetitive nerve stimulation (RNS) test. These patients were indicated for SFEMG at the Electromyography Unit, Department of General Neurology, People's Hospital 115, from March to July 2025. Results: Positive SFEMG findings were recorded in 80% of patients (4/5). Among them, three patients met the criteria of abnormal MCD (mean consecutive difference) in individual fiber pairs, and one patient met the criteria of abnormal average MCD across 20 fiber pairs. Anti-acetylcholine receptor antibody tests were positive in 40% (2/5), negative in 40% (2/5), and not performed in one patient (20%). All patients completed the procedure without any serious adverse events. Conclusion and Recommendations: The SFEMG protocol for diagnosing myasthenia gravis at People's Hospital 115 was developed in line with international guidelines and adapted to national regulations. Initial implementation showed the protocol to be feasible, effective, and safe, supporting improved diagnosis and treatment of myasthenia gravis. SFEMG should be considered in patients with suspected myasthenia gravis and negative 3Hz RNS test result and negative anti-acetylcholine receptor (AChR) antibodies in clinical practice.