Assessment of fatigue and autonomic dysfunction in myasthenia gravis – case report

Kwiatkowska Klaudia, Lamtych Martyna, Kubiak Karolina, Litwa Ewelina, Badiuk Nataliia. Assessment of fatigue and autonomic dysfunction in myasthenia gravis – case report. Journal of Education, Health and Sport. 2019;9(5):667-675. eISNN 2391-8306. DOI http://dx.doi.org/10.5281/zenodo.3375836

http://ojs.ukw.edu.pl/index.php/johs/article/view/7322

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This is an open access article licensed under the terms of the Creative Commons Attribution Non commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted, non commercial

use, distribution and reproduction in any medium, provided the work is properly cited.

The authors declare that there is no conflict of interests regarding the publication of this paper.

Received: 19.05.2019. Revised: 22.05.2019. Accepted: 31.05.2019.

Assessment of fatigue and autonomic dysfunction in myasthenia gravis – case report

Klaudia Kwiatkowska¹, Martyna Lamtych¹, Karolina Kubiak¹,

Ewelina Litwa², Nataliia Badiuk³

¹Student Scientific Circle at Chair of Hygiene, Epidemiology and Ergonomics, Faculty of Health Sciences, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland

²Scientific Circle at Department of Hygiene, Epidemiology and Ergonomics. Division of Ergonomics and Exercise Physiology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Poland

³State Enterprise Ukrainian Research Institute for Medicine of Transport, Ministry of Health of Ukraine, Odesa, Ukraine

Abstract

Introduction: Myasthenia gravis (MG) is an autoimmune disease in which neuromuscular conduction disorders occur. The reason is the loss of acetylcholine receptors and the presence of antibodies directed against these receptors. The most characteristic symptoms of myasthenia gravis are: tenderness and weakness of striated muscles, which intensify particularly during exercise and in the evening. Non-motor symptoms such as: fatigue, disorders of the autonomic nervous system can be asymptomatic, and in a significant proportion of cases significantly affect the quality of life. A full understanding of non-motors symptoms is needed to treat patients with MG. The aim of the study was to present the characteristics of non-motor symptoms on the example of a patient with myasthenia gravis.

Material and methods: A 50-year-old woman who had been suffering from myasthenia gravis for 23 years was examined. Chalder Fatigue Scale, Epworth Sleepiness Scale, Orthostatic Grading Scale were used to evaluate non-motor symptoms. The orthostatic reaction was tested using the tilt test.

Results: The most frequently reported non-motors symptoms in the patient were: chronic fatigue, sleep disturbances and cardiovascular symptoms (orthostatic intolerance, weakness).

Conclusions: Myasthenia gravis is characterized by a large variability of symptoms. An important part of the clinical picture are non-motor symptoms that can affect the functioning of patients in everyday life.

Key words: myasthenia gravis, non-motor symptoms, fatigue