Clinical Research Directory

Thorough clinical examination: 1\. General examination including general look, vital signs and anthropometric measurements. 2\. Scale system include gross motor function and muscle power(Quantitative Myasthenia Gravis Scale) \[36\] 3. detailed neurological examination including motor ,sensory and reflexes. (C) Investigations: 1. Electrophysiological testing: EMG : is especially useful in diagnosis of seronegative MG and congenital myasthenic syndromes. NCS: including repetitive nerve stimulation test (r NST) 2. laboratory studies: * Serology. Detection of antibodies to the AChR supports the diagnosis of JMG. In young children where AChR antibodies are negative this can lead to difficulty in differentiating from CMS. * Thyroid function tests : 3. Imaging: • CT chest: Although thymoma in children is rare, the thymus must be imaged once JMG has been diagnosed. 4. molecular studies (when possible).

C) Investigations: 1. Electrophysiological testing: EMG : is especially useful in diagnosis of seronegative MG and congenital myasthenic syndromes. NCS: including repetitive nerve stimulation test (r NST) 2. laboratory studies: * Serology. Detection of antibodies to the AChR supports the diagnosis of JMG. In young children where AChR antibodies are negative this can lead to difficulty in differentiating from CMS. * Thyroid function tests : 3. Imaging: • CT chest: Although thymoma in children is rare, the thymus must be imaged once JMG has been diagnosed. 4. molecular studies (when possible).