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

Few 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 associa...

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Bibliographic Details
Published in:BMC neurology 2013-10, Vol.13 (1), p.132-132, Article 132
Main Authors: Elsais, Ahmed, Wyller, Vegard B, Loge, Jon Håvard, Kerty, Emilia
Format: Article
Language:eng ; nor
Subjects:
Adult
Age
Aged
Autoimmune diseases
Autonomic Nervous System Diseases - epidemiology
Autonomic Nervous System Diseases - etiology
Care and treatment
Case-Control Studies
Cholinesterase Inhibitors - therapeutic use
Chronic fatigue syndrome
Chronic illnesses
Complications and side effects
Computer software industry
Diagnosis
Disease
Fatigue
Fatigue - diagnosis
Fatigue - drug therapy
Fatigue - epidemiology
Fatigue - etiology
Female
Humans
Linear Models
Male
Medical research
Medicine, Experimental
Middle Aged
Muscles - pathology
Myasthenia gravis
Myasthenia Gravis - complications
Myasthenia Gravis - drug therapy
Myasthenia Gravis - epidemiology
Myasthenia Gravis - pathology
Neurologic Examination
Neurophysiology
Patient outcomes
Patients
Questionnaires
Retrospective Studies
Risk factors
Sleep disorders
Statistics, Nonparametric
Surveys and Questionnaires
Young Adult
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Summary:Few 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. Eighty 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. Forty-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). Norwegian 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.
ISSN:1471-2377
1471-2377
DOI:10.1186/1471-2377-13-132