Neostigmine test

The neostigmine test is one of the important means of diagnosing myasthenia gravis (MG). For patients with suspected myasthenia gravis, it can be divided into two types. Most patients find obvious muscle weakness during muscle strength test. The test or the phenolamine test (Tengxilong test). Basic Information Specialist classification: growth and development check classification: physical examination Applicable gender: whether men and women apply fasting: not fasting Analysis results: Below normal: Normal value: no Above normal: negative: Normally, the neostigmine test was negative. That is, after the end of the test, each item is averaged 6 times after the injection, and the number of decimal places is taken as the positive boundary value of the item, which is less than 1/2. Positive: Positive neostigmine test can be diagnosed as myasthenia gravis. Tips: Before performing the neostigmine test, check muscle strength and check muscle function beforehand. Normal value The neostigmine test was negative. That is, after the end of the test, each item is averaged 6 times after the injection, and the number of decimal places is taken as the positive boundary value of the item, which is less than 1/2. Clinical significance Abnormal results: Positive neostigmine test can be diagnosed as myasthenia gravis. People who need to be examined: patients with myasthenia gravis. Positive results may be diseases: pediatric myasthenia gravis, myasthenia gravis crisis, myasthenia gravis, Lambert-Eaton syndrome, pregnancy with myasthenia gravis, elderly motor neuron disease, elderly myasthenia gravis Pre-inspection contraindications: Before performing the neostigmine test, check muscle strength and check muscle function before. Requirements for inspection: 1. The doctor asks to continue to blink and look upwards, keep blinking and look upwards or look at the left and right sides. 2, when the neck and head fatigue test, put a cushion or pillow under the head to prevent the head from falling too fast and causing head injury. Inspection process The upper jaw fatigue test: the patient continues to blink and look upwards, recording the time required for the eyelid to sag (s), and the eyelid sag above the cornea at 9 to 3 o'clock is the standard. Splitting size: Let the patient's eyes look straight ahead or top view, and measure the maximum distance (mm) between the upper and lower cleft palate. The abduction is exposed to the white: the patient is gazing at the left and right sides, and the number of mm of the abduction and inward whiteness is recorded, and the number of white eyes of one side of the eye is added to the number of mm of the inner white. Reck-necked head fatigue test: The patient is placed on his back, maximally bends his head, and records the time (s) required to induce neck fatigue (head and neck begin to recline). Upper Limb Fatigue Test: The two arms are lifted horizontally to record the time (s) required to induce upper limb fatigue (the upper limb and the body begin to fall less than 90 degrees or begin to sag). Lower limb fatigue test: The patient was placed in the supine position. Both lower limbs were hip and knee flexed at 90 degrees, and the time (s) required to induce lower limb fatigue (bending the hip, bending the knee to start at 90 degrees or starting to sag) was recorded. Score: double vision muscle weakness, dysarthria, dyspnea 0: no double vision normal, no dysarthria is normal 1: When looking at one direction, there is a difference in the ability of the closed eye to close the eye. The astigmatism is not complete. After a long time, the voice becomes low and the activity is short. 2: When looking at the two directions, there are double vision and close eyesight difference, which can barely close the eye crack, and the emphysic sign disappears and begins to talk. 3: When looking at the three directions, there are double eyes that can't be closed, and the drums are leaking and hoarse. 4: There are double visions in all directions, the mask-like face is low, and it is impossible to hear the need for oxygen or artificial assistance. Judgment of positive and negative tests: Each indicator was measured every 10 minutes before and after the injection of neostigmine, and the difference between the time and the data before injection was recorded every 10 minutes after the injection. After the end of the experiment, each item was averaged 6 times after the injection, and the 1st digit after the decimal point was taken as the positive boundary value of the item, and the positive boundary value equal to or greater than 1/2 was determined as the suspected positive boundary value. , less than 1/2 This value is a negative boundary value. As long as one of the indicators is positive, the neostigmine test is positive. Note: Upper and lower limb fatigue test>120s. The measurement was stopped when the upper jaw fatigue test was >60s. Calculated by 120 and 60s respectively. Not suitable for the crowd 1. Some muscles are weak when fatigue occurs, and there are no patients with weakness in the temporary examination. 2. Patients with severe injuries or disabilities on the extremities and neck. Adverse reactions and risks Generally no adverse reactions.