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Manual muscle strength examinations were normal in all patients.Six patients had mildly elevated CKs(range 223 to 768 IU/l);otherwise, laboratory tests were unremarkable.NCS were normal except in two patients with carpal tunnel syndrome.Quantitative EMGs were normal.One patient had mildly increased jitter on single-fiber EMG.Muscle biopsies demonstrated minor nonspecific abnormalities in five patients(i.e.,increased central nuclei,rare necrotic fibers,tubular aggregates.Despite severe subjective symptoms,most of our patients had no objective evidence of neuromuscular disease.Mildly increased CKs or nonspecific histologic abnormalities on muscle biopsy were evident in 8 patients but were not believed to be clinically significant in most.We found no evidence of a specific neuromuscular disorder in any patient.Exposures to toxins during the Persian Gulf War were not likely responsible for out patients'symptoms. |
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