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Myasthenia Gravis and Endurance Exercise

Scheer, Bernd Volker MD; Valero-Burgos, Encarna MD; Costa, Ricardo PhD

American Journal of Physical Medicine & Rehabilitation: August 2012 - Volume 91 - Issue 8 - p 725–727
doi: 10.1097/PHM.0b013e31824663c6
Case Report

ABSTRACT This is the first report of a runner with myasthenia gravis who completed an ultra endurance event. Myasthenia gravis, a neuromuscular disease that usually results in skeletal muscle weakness, which worsens with exercise and strenuous aerobic exercise, is generally contraindicated. Our runner completed a 220-km, 5-day ultramarathon and presented with various symptoms including muscular skeletal weakness, cramps, generalized fatigue, unintelligible speech, involuntary eye and mouth movements, problems swallowing, food lodging in his throat, and problems breathing. Risk factors identified for exacerbations are running in extreme temperatures, prolonged runs (especially a distance of 30 km or more), running uphill, lack of sleep, and stress. The medical team was in the novel situation to look after a runner with myasthenia gravis and needed to be aware of the patient’s condition, symptoms, and risk factors to safely care for him.

From the AAUT, Team Axarsport, Alicante, Spain (BVS); Emergency Department, Vinalopo Salud Hospital, Elche, Spain (EV-B); and Faculty of Health and Life Sciences, Coventry University, UK (RC).

All correspondence and requests for reprints should be addressed to: Bernd Volker Scheer, MD, Sports Medicine Department, University of Heidelberg, Im Neunheimer Feld 710, 69120 Heidelberg, Germany.

Financial disclosure statements have been obtained, and no conflicts of interest have been reported by the authors or by any individuals in control of the content of this article.

© 2012 Lippincott Williams & Wilkins, Inc.