I have not had the SFEMG study so I can only speak to the standard and repetitive stimulation studies. Of course every doctor performs these studies differently so I can only give you an idea of how it will go. I am also a medical assistant in my own neuro's office and I assist with the EMG and repetitive stimulation studies routinely.

Typically, the first part of the study is to check your nerves. It uses electric stimulation to evoke a response from you muscles. They should start out rather mild and increase as it goes. This feels kind of like when you are wearing socks and run your feet on the carpet and get shocked. Or at least that's what if felt like to me. The second half of the test is the muscle test. For this part they use a very thin needle (like what is used in acupuncture). The put the needle into certain muscles while you are relaxed and after they've analyzed it in the resting state, your doctor or tech will ask you to activate the muscle with certain movements. Finally, if they are doing a rep stim test that will be performed last. There are only a couple of muscles/nerves tested during this part of the test. Typically it is in your hand and your neck. This is basically the same as the first part of the test except that you will be asked to fatigue those muscles for a period of time and then the stimulation is done in a rapid fire kind of way for a total of 5 times for each area. For example, if they are testing your hand they would test your pinky finger so they will find the appropriate level of stim and then they will tell you that they are going to do the stimulation rapidly. So basically it will be five times very quickly so, boom, boom, boom, boom, boom without any break between them. They will then ask you to fatigue the area by creating resistance as you push against it. They will do that for about a minute and then do the rep stim again. Then they do it at one minute intervals about four times.

If you are looking at the result on the monitor with the doctor the results should look a bit like a U on the screen if it detects MG. It the bars on the monitor will usually start off high and then go down and back up again.

That's about it. I hope this isn't too much information for you. If have any questions or want to know more, please feel free to send me a private question or reply here. I will do what I can to help you out with answers. Others here have had the SFEMG and can give you specifics for that study and/or can contribute there experiences in this area.

I hope everything goes well. Please let us know how it went when you get the chance. Hugs.
Angie

I had an SFEMG yesterday and described it here: http://www.dailystrength.org/c/Myasthenia_Gravis/forum/18424709-scientific-questiondebate/page-2

I would ask the doctor what she hopes to learn from the study and how it would influence your treatment. A positive SFEMG is not usually repeated. It is not an easy test to perform and not many are trained to do it well. If yours is for training purposes and you don't mind, then that is one thing, but risking a diagnosis because the SFEMG is negative ( which happens even with positive blood studies sometimes), is scary, and the test is at best uncomfortable.

If you do have the studies, be sure to check the Links Group about preparing for EMGs. Good luck, b.

I am not sure what she wants to learn if she is pretty confident. In the diagnosis based on my bloodworm. She has taken some tests to have a baseline, ct scan, pulmonary and is scheduling bone density as well, maybe this is another baseline test? Either way, I see her before the test so I guess I'll add it to the list of questions.

Thanks so much for your input!

Oh and there will be no "training" on me, right now I am just not up to putting myself out there for someone's training ... But I believe she was planning to do it herself, and she certainly is done training and only treats MG and one other disease.. LEMS

Maureen, I was diagnosed with MG via "Stimulated" SFEMG performed by an expert with 30+ years experience doing a rarely performed type of SFEMG which is the ONLY test he relies on. I switched to a different hospital to consolidate my care... and have now lost my definitive MG diagnosis due to having a normal "Volitional" SFEMG performed by a Fellow who was trying to establish a "baseline" for my case. It was followed several months later by another normal "Volitional" SFEMG performed by a skilled young Neuro. I am now being evaluated for a similar, but more rare condition, Mitochondrial Myopathy (a differential diagnosis for MG).

Some people here with severe, resistant MG have NEVER had an abnormal SFEMG. If you have the test, I hope it goes well and that you receive the treatment you need.

Hugs,
Rosie

Hmm interesting Rosie, I would imagine that since I have been diagnosed clinically that my diagnosis would remain... It appears we have some talking to do before I submit. She is pretty reasonable so I will see how it goes. Thanks for that tidbit. If I were to have to o off mestonin or start over I think I would be very upset. Thank for the heads up!

M

I have just recently been diagnosed (?) with MG. All blood work, cat scan, emg and ncv have come back negative. I am on Mestinon (60mg) 4x day. I definitely can tell when next dose is due. Prednisone (20mg) a day. I think my neuro is waiting to up it till after sfemg. Since there is only one dr. in her hospital that performs it I have to wait 2 weeks. Is there anyone else who's tests have come back negative??? I was also told that there is a big difference with an EMG and a SFEMG?

Hey there my friend...First off glad you found new dr and like her..She isnt in Kinston is she by any chance cause thats where mine is and love her a DR ALAMPUR...? Anyway Im sorry cant give you much advice Ive never had either test but just wanted to wish you luck and hope goes well and Ill be thinking of you...Keep us posted..I see people have responded that have had and know about the test so hope that all helps you..Im just dishing out the hugs today I guess! Big Hugs Jacki

Hi M ,

I've have had both of those tests quite some time ago and as others have said it's certainly uncomfortable. I specifically remember the single fiber as the location of choice by my Doc was above my eye brow as the nerves there are quite sensitive . it was quite "uncomfortable " to say the least but as Angie said boom , boom a few times and it's over .

I'm curious like some of the others as to the reason why he or she wants to do this study .

Good luck , you will do great ,

Chris

CJ... This thread came back up... that was back in march, what a diference a few moths make....

I just had both test done last week also. First of all let me say that my new blood test doesnt show any antibodies at all. So my new neuro in Oklahoma City wanted to do the EMG and SFEMG test. it was at time uncomfortable but bearable all the way through it. just relax and all will go good. he did come back with a few muscles that showed jitter on the test. As i still have symptoms of MG even with the negative antibodies he says that im seronegative MG. i think in this case it helped to determine i still have MG so i will be starting to have once a month IVIG treatments soon. each person is different when test are administered, but for me the test wasnt to bad, i think the scariest part of anything is the unknown and it helped to get all the information on the test before actually doing it. hope all turns out well.

I don't like these tests.....State of arousal of immune system, and experimenter bias (differences from one tester to another for whatever reasons) are factors which will always obfuscate the true reading of the targeted variable, namely, the extent to which disease is present... 1st test, the so called, "baseline reading," EMG shows mild impairment. 2nd test 2 yrs later EMG shows moderate to severe impairment. ...Oh dear, your MG is getting worse... Or, unbeknown to both you, and the tester, you are coming down with Shingles, and your immune system is in a very high state of arousal. The same factors confound the results of Spirometry at your friendly neighborhood pulmonologist. To a somewhat lesser degree, because of differing mechanics... Yes, SFEMG does identify jitter, and that is important...HG007