Muscle fiber conduction velocity in the diagnosis of familial hypokalemic periodic paralysis—invasive versus surface determination

Muscle fiber conduction velocity (MFCV) in the brachial biceps muscle was determined in a large family of patients with hypokalemic periodic paralysis (HOPP) by both a surface and an invasive method. Other surface EMG parameters and the muscle force were also determined. Both the surface and the invasive method showed a significantly lower mean MFCV in the proven gene carriers but only the invasive method showed a lower MFCV in all proven carriers. It can be concluded that MFCV determination is a reliable method to detect the membrane defect in HOPP carriers and that the invasive method is not only easy to perform, but also more sensitive. The muscle force and the integrated EMG at maximal voluntary contraction were lower in the carrier group. A positive correlation between the surface MFCV and the neuromuscular efficiency (the quotient of force and integrated EMG) was found in the controls but not in the HOPP carriers. Since type II fibers have a higher neuromuscular efficiency, this suggests a preferential involvement of type II fibers in HOPP.