Sensitivity of Repetitive Nerve Stimulation Performed in the Evening vs in the Morning in Myasthenia Gravis

Summary

Myasthenia gravis (MG) is the autoimmune disorder affecting the neuromuscular junction, characterized by fatigue, which increases gradually through the day. The repetitive nerve stimulation (RNS) remains the key diagnostic test in MG, however its sensitivity, especially in ocular form of MG is not satisfactory. In this study, investigators want to assess the impact of the time of the day on the sensitivity of the RNS. We hypothesize the RNS performed in the evening may be more sensitive than in the morning.

Eligibility

Inclusion Criteria:

* Patients with suspected or diagnosed myasthenia gravis (ocular and generalized form)
* Patients with performed or planned determination of anti-AChrR and anti-MUSK antibodies.
* Disease severity of at least 1 in the classification of the severity of myasthenia gravis according to the recommendations of the Myasthenia Gravis Foundation of America

Exclusion Criteria:

* respiratory failure
* severe bulbar symptoms
* pharmacotherapy with substances that may worsen neuromuscular transmission disorders
* current infection
* coexisting diseases of the peripheral nervous system which may affect the result of the fatigue test, e.g. polyneuropathy or myopathy
* cognitive and behavioral disorders that may negatively affect patient's adherence to study protocol
* Medication with steroids due to myasthenia
* Severity of myasthenia that makes the discontinuation of acetylcholinesterase inhibitors unsafe.

Conditions2

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