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Dr. Rubin reports no financial relationships relevant to this field of study.
Source: Oh SJ, et al. One-minute exercise is best for evaluation of postexercise exhaustion in myasthenia gravis. Muscle Nerve 2014;50:413-416.
Friedrich Jolly (1844-1904), German neurologist and psychiatrist, student of Georg Meissner (Meissner’s corpuscles), and pioneer of myasthenia research, described the electrophysiological aspects of myasthenic fatigue, which form the basis of the repetitive nerve stimulation (RNS) test that bears his name. An abnormal "Jolly" test is a reproducible decrement of muscle amplitude of > 10% during 3 Hz repetitive stimulation, and results from a decreased safety margin, due to abnormal acetylcholine (Ach) receptors, and consequent failure to reach threshold depolarization with progressively fewer muscle fibers depolarizing as nerve terminals become partially depleted of ACh. Exercise exacerbates this decrement, known as postexercise exhaustion (PEE), but the best exercise duration to achieve PEE is debatable, and is the subject of this study.
Among 45 myasthenia...