Limitations of Single-Fiber EMG

While normative data for fiber density, mean consec­utive difference, and jitter have been reported for dif­ferent muscles among different pediatric age groups (31), this procedure is difficult to use in younger chil­dren with limited ability to cooperate. Alternatively, a stimulated single-fiber EMG study may be obtained under general anesthesia in those suspected of a congenital myasthenic syndrome, and this technique has yielded excellent sensitivity and specificity for identification of a neuromuscular transmission dis­order (32-34).