• Neurophysiol Clin · Feb 2019

    Non-invasive evaluation of sudomotor function in patients with myasthenia gravis.

    • Catarina Falcão de Campos, Pedro Viana, Isabel de Castro, José Castro, Mamede de Carvalho, and Isabel Conceição.
    • Department of Neurosciences and Mental Health, Hospital de Santa Maria-CHLN, avenue Professor-Egas-Moniz, 1648-028 Lisbon, Portugal; IMM and Institute of Physiology, Faculdade de Medicina, Universidade de Lisboa, Lisboa, Portugal. Electronic address: catarinahfcampos@gmail.com.
    • Neurophysiol Clin. 2019 Feb 1; 49 (1): 81-86.

    ObjectivesMyasthenia gravis (MG) is an autoimmune disease associated with antibodies against the nicotinic muscle acetylcholine receptor (AChR) at the neuromuscular junction. Dysautonomia has been previously described in MG. Electrochemical skin conductance (ESC), assessed by Sudoscan®, is a non-invasive method that allows evaluation of sudomotor function. Since sweat glands are innervated by sudomotor, postganglionic, cholinergic sympathetic C-fibers, we hypothesized that ESC could be a reliable method for assessing autonomic dysfunction in MG.MethodsESC measurements were prospectively assessed in patients with generalized MG and in healthy controls. Patients with diabetes mellitus, anticholinergic medication or electrophysiological findings of peripheral neuropathy were excluded. Data regarding demographic and disease features were collected. Presence of autonomic symptoms in patients with MG was assessed by Compass-31. For statistical analysis we performed student t-test and Chi2 test for comparison between both groups.ResultsWe included 24 patients (mean age of 46.4±10.6, 75% women, mean disease duration 12.5 years, 62.5% positive for AChR antibodies) and 37 controls. We found no difference in either foot (P=0.13) or hand (P=0.83) ESC measurements between patients and controls, even after correcting for age.ConclusionWe could not prove the presence of autonomic sympathetic dysfunction in our cohort of MG patients when assessed by Sudoscan®. In addition, Compass-31 was not a useful questionnaire in this clinical context.Copyright © 2018 Elsevier Masson SAS. All rights reserved.

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