Table 2.

Protocol for administering the edrophonium challenge test in participants with movement disorders

Evaluation of participants’ symptoms

1. Videotape (1 min) recording of the objective symptoms before the injection

2. Normal saline injection

3. Two min after the injection: videotape recording

4. Four min after the injection: videotape recording

5. Six min after the injection: videotape recording

6. Eight min after the injection: videotape recording

7. Ten min after the injection: videotape recording

8. Visual analog scale (VAS) test (evaluation after the normal saline injection)

9. Edrophonium injection

10. Two min after the injection: videotape recording

11. Four min after the injection: videotape recording

12. Six min after the injection: videotape recording

13. Eight min after the injection: videotape recording

14. Ten min after the injection: videotape recording

15. VAS test (evaluation after the edrophonium injection)

Evaluation of the video by three movement disorder specialists

1. We chose videos of the isotonic sodium chloride solution and edrophonium injections, which were randomly referred to as A and B, respectively

2. We chose the video acquired 8 min after the administration of A or B, because the symptoms changed the most about 8 min after the edrophonium administration

3. The video before the injection was reviewed

4. The video after the injection of A was reviewed

5. The modified VAS assessment was performed (the value after the A injection compared to that before the injection was used as the midline)

6. The video before the injection of B was reviewed

7. The video after the injection of B was reviewed

8. The modified VAS assessment was performed (the value after the B injection compared to that before the injection was used as the midline)

We evaluated videos before and after the injection of A or B as a set.

We randomly presented the videos before and after the injection of A or B of cervical dystonia, hand dystonia, and hemifacial spasm to the specialists.