Abstract

INTRODUCTION

Dr Donald B. Sanders, when introducing Erik Stålberg who invented single fibre electromyography (EMG), at a meeting in Uppsala in 2001, told a true story about a lady with puzzling symptoms, suspected of having myasthenia gravis. Finally after the diagnosis of myasthenia was made on the basis of single fibre EMG, the lady said to Dr Sanders, ‘Doctor, I just thank the Lord he made someone smart enough to figure all this out, so you doctors could help me!’ Single fibre EMG practitioners are used to hearing words like this because the technique can be the only test to show an abnormal result when repetitive nerve stimulation, the tensilon test and acetylcholine receptor antibodies are negative in myasthenia gravis. Although the major clinical role of single fibre EMG is in the diagnosis of myasthenia gravis, it is helpful in some other conditions, such as the congenital myasthenias, Lambert–Eaton