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- Kouyoumdjian, Joao A., et al.
(author)
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Concentric needle jitter in stimulated frontalis in 20 healthy subjects
- 2012
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In: Muscle and Nerve. - : Wiley. - 0148-639X .- 1097-4598. ; 45:2, s. 276-278
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Journal article (peer-reviewed)abstract
- Normative data for jitter parameters using a disposable concentric needle have been presented in a few studies. Jitter, expressed as the mean consecutive difference (MCD), was measured in the frontalis muscle in 20 subjects by percutaneous bar stimulation of the temporal nerve branch. The mean MCD for individual studies (20) and for all potentials (600) were 16.05 +/- 2.73 mu s and 16.05 +/- 5.96 mu s, respectively. The suggested limit for mean MCD is 22 mu s and for outliers is 28 mu s.
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- Kouyoumdjian, Joao A., et al.
(author)
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Concentric needle jitter on voluntary activated frontalis in 20 healthy subjects
- 2013
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In: Muscle and Nerve. - : Wiley. - 0148-639X .- 1097-4598. ; 47:3, s. 440-442
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Journal article (peer-reviewed)abstract
- Introduction: Normative data for jitter parameters using a disposable concentric needle have been described in a few studies. Methods: Jitter, expressed as the mean consecutive difference (MCD), was measured in the frontalis muscle in 20 subjects by voluntary contraction. Results: Mean MCD for individual studies (20, Gaussian), all potentials (400, non-Gaussian), and 18th highest value (20, Gaussian) were 19.9 +/- 2.9 s, 19.9 +/- 6.6 s, and 26.9 +/- 4.4 s, respectively. Conclusion: The suggested upper normal limit for mean MCD is 26 s and for outliers is 36 s.
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- Sanders, Donald B., et al.
(author)
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Single fiber electromyography and measuring jitter with concentric needle electrodes
- 2022
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In: Muscle and Nerve. - : John Wiley & Sons. - 0148-639X .- 1097-4598. ; 66:2, s. 118-130
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Journal article (peer-reviewed)abstract
- This monograph contains descriptions of the single fiber electromyography (SFEMG) method and of the more recently implemented method of recording jitter with concentric needle electrodes (CNEs). SFEMG records action potentials from single muscle fibers (SFAPs), which permits measuring fiber density (FD), a sensitive measure of reinnervation, and jitter, a sensitive measure of abnormal neuromuscular transmission (NMT). With voluntary activation, jitter is measured between two SFAPs with acceptable amplitude and rise time. With activation by axon stimulation, jitter is measured between the stimulus and individual SFAPs. Pitfalls due to unstable triggers and inconstant firing rates during voluntary activation and subliminal stimulation during axon stimulation should be identified and avoided. In CNE recordings, spikes with shoulders or rising phases that are not parallel are produced by summation of SFAPS; these should be excluded and reference values for CNE jitter should be used. CNE and SFEMG have similar and very high sensitivity in detecting increased jitter, as in myasthenia gravis and other myasthenic conditions. However, jitter is also seen in ongoing reinnervation and some myopathic conditions. With SFEMG, these can be identified by increased FD; however, FD cannot be measured with CNE, and conventional electromyography should be performed in muscles with increased jitter to detect neurogenic or myogenic abnormalities. Jitter is abnormal after injections of botulinum toxin, even in muscles remote from the injection site, and can persist for 6 mo or more. This can complicate the detection or exclusion of abnormal NMT.
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