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  • Title: Concentric or monopolar electrode for jitter determination in orbicularis oculi.
    Author: Oliveira Santos M, Swash M, de Carvalho M.
    Journal: Clin Neurophysiol; 2018 Dec; 129(12):2552-2556. PubMed ID: 30388614.
    Abstract:
    OBJECTIVES: To investigate if monopolar (MN) and concentric (CN) electrodes are equivalent for volitional contraction jitter estimation in orbicularis oculi (OO), and to study the effect of selecting a specific high-pass filter. METHODS: We studied neuromuscular jitter in OO on both sides in 100 consecutive patients with a clinical diagnosis of ocular myasthenia gravis (MG). We used either MN (50 patients) or CN (50 patients) electrodes in individual patients, according to a randomised protocol, with a 1kH high pass filter on one side and a 3kH filter on the other. Ten or more potential pairs were studied on each side. RESULTS: 48 patients had a definite clinical diagnosis of ocular MG, and 52 of mimicking-disorders, who were analysed as controls. In controls, jitter (MCD) showed a normal distribution independent of the electrode type or filter settings. The mean jitter value and the number of abnormal pairs (>10%) was similar in MN and CN recordings, with both 1 kHz and 3 kHz filters. Sensitivity was 73% for mean jitter and 94% for number of abnormal pairs. Specificity was 100%. CONCLUSIONS: The jitter in OO using MN or CN was similar in controls and the diagnostic sensitivity was similar using either electrode in patients with ocular MG. The use of high-pass filters of 1 or 3 kHz did not influence these results. SIGNIFICANCE: MN and CN are both suitable for determining volitional jitter in OO.
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