Airway limitation and exercise intolerance in well-regulated myasthenia gravis patients

Elsais, Ahmed; Johansen, B.V.; Kerty, Emı́lia

doi:10.1111/j.1600-0404.2010.01369.x

Cited by 21 publications

(26 citation statements)

References 49 publications

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“…Medication can influence both fatigue and autonomic functions. We concluded in a previous study that well-regulated MG patients with fatigue showed an obstructive pattern in pulmonary function tests and this was more pronounced in patients using AChEI [23]. Sixty one per cent (50/82) of the MG patients in our study used AChEI, which is suspected to alter autonomic functions, but we did not find that use of AChEI was an independent explanatory variable, although patients using them had slightly higher total fatigue scores than controls (mean ± SD: 15.0 ± 6.2 vs 13.8 ± 4.2).…”

Section: Discussionmentioning

confidence: 99%

Fatigue in myasthenia gravis: is it more than muscular weakness?

et al. 2013

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BackgroundFew studies have focused on fatigue in myasthenia gravis (MG), and fatigue in relation to the autonomic system has never been systematically explored in these patients. The study aimed to document the prevalence of MG-related fatigue in ethnic Norwegians and to examine whether MG severity is associated with symptoms of autonomic disturbance, which in turn is associated with fatigue and functional disability.MethodsEighty two of the 97 who fulfilled the study inclusion criteria participated in the study. Controls were 410 age- and sex-matched subjects drawn from a normative sample (n = 2136) representative of the Norwegian population. Bivariate analyses and multivariate linear regression analyses were used to assess associations between questionnaire-reported MG severity, symptoms of autonomic disturbance, fatigue (mental and physical) and functional disability.ResultsForty-four per cent (36/82) of patients fulfilled the criteria for fatigue compared with 22% (90/410) of controls (odds ratio 2.0; p = 0.003). Twenty-one per cent of patients (17/82) met the criteria for chronic fatigue versus 12% (48/410) of controls (odds ratio 1.96; p = 0.03). MG patients had higher total fatigue scores than controls (p < 0.001) and a high prevalence of autonomic symptoms, especially poor thermoregulation and sleep disturbance. According to multivariate analyses controlled for MG score, symptoms of autonomic disturbances were independently positively associated with fatigue (p < 0.001), and fatigue was independently negatively associated with functional level (p < 0.001).ConclusionNorwegian ethnic patients with MG have higher levels of fatigue and a higher prevalence of chronic fatigue than controls, even in patients in full remission. MG severity is highly suggestive to be associated with symptoms of autonomic disturbance, which in turn is associated with fatigue and the level of functional disability.

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Section: Discussionmentioning

confidence: 99%

Fatigue in myasthenia gravis: is it more than muscular weakness?

et al. 2013

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“…In the literature, there are a few case reports, but none have described MG deterioration from physical activity, as well as a few studies on respiratory muscle training . Nevertheless, another study indicated exercise intolerance in well‐regulated MG patients . The benefits of physical exercise are well known, and general recommendations regarding physical activity are available for healthy adults .…”

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confidence: 99%

Physical exercise in myasthenia gravis is safe and improves neuromuscular parameters and physical performance-based measures: A pilot study

et al. 2017

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“…This was more marked in patients on acetylcholine esterase inhibitors (Elsais et al, 2010). In myasthenic crisis, bronchodilators may be useful in maintaining airway patency and overcoming bronchospasm.…”

Section: Bronchodilator Therapymentioning

confidence: 91%