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One‐minute exercise is best for evaluation of postexercise exhaustion in myasthenia gravis

Introduction: To find the best exercise duration for postexercise exhaustion by decrement (PEE‐D) in myasthenia gravis (MG). Methods: In 32 tests in 32 MG patients, repetitive nerve stimulation was performed in the abductor digiti quinti muscle. The 3 Hz responses for 2 s were obtained with supramaximal stimulation at rest, and immediately after (PE0), 30 s after (PE30s), and 1, 2, 3, and 4 min after 10‐s, 30‐s, and 1‐min exercises. Results: Compared with the decrement at rest, a significantly greater decrement was found at PE2m and PE3m after 30‐s exercise, and at PE2m, PE3m, and PE4m after 1‐min exercise. In 11 patients who showed a decremental response only with exercise, PEE‐D was observed in 5 after 30‐s exercise and in 8 after 1‐min exercise. Conclusions: One‐minute exercise is best for evaluation of PEE‐D in MG. Muscle Nerve 50: 413–416, 2014