REPETITIVE RESPONSE TO SINGLE STIMULATION

from M. Al-Lozi

Two CMAPs after single stimulus Second CMAP (Arrow) Smaller than the first Follows first CMAP with consistent latency: Independent of site of nerve stimulation Due to prolonged action of acetylcholine at neuromuscular junctions Occurs with Mysathenic slow AChR channel syndromes Acetylcholinesterase inhibition: Toxins; AChE inhibitor overdose (Cholinergic crisis)

from M. Al-Lozi

Second response (Arrows) is reduced after repetitive (10 Hz) nerve stimulation