{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T23:28:44Z","timestamp":1790206124240,"version":"4.1.0"},"reference-count":19,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2007,12,10]],"date-time":"2007-12-10T00:00:00Z","timestamp":1197244800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Muscle and Nerve"],"published-print":{"date-parts":[[2008,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The aim of this prospective study was to assess whether extra discharges (EDs), sometimes following the compound muscle action potential, could be used as a neurophysiological indicator of overdose of acetylcholinesterase inhibitors (AChEIs) in patients with myasthenia gravis (MG). The characteristics and frequency of EDs were explored and the correlation of EDs with cholinergic side effects was also determined. Twenty\u2010two MG patients (14 women, 8 men; 61 \u00b1 16 years of age) with daily AChEI treatment were examined. The mean disease duration was 10 years (range 2\u201362 years) and all patients had been treated with AChEI since MG onset. Both single and repetitive stimulation of the ulnar and accessory nerves were performed before and 60 min after oral pyridostigmine bromide (PB) administration and after additional edrophonium injection. Fatigue, side effects, and AChE activity in blood were assessed before and 60 min after PB intake. The daily dose of PB ranged from 150 to 900 mg\/day. Fourteen patients (64%) experienced daily cholinergic adverse effects, and muscarinic side effects correlated with AChE activity. Eleven patients (50%) developed EDs after oral PB. Among the eight patients with daily nicotinic side effects, EDs were significantly (<jats:italic>P<\/jats:italic> &lt; 0.05) more common. Additionally, older patients were more prone to develop cholinergic side effects and EDs. Thus, when EDs are found, patients should be asked about daily muscular symptoms, which may be related to AChEI treatment and not solely to MG. Muscle Nerve, 2007<\/jats:p>","DOI":"10.1002\/mus.20935","type":"journal-article","created":{"date-parts":[[2007,12,10]],"date-time":"2007-12-10T20:16:47Z","timestamp":1197317807000},"page":"300-307","source":"Crossref","is-referenced-by-count":38,"title":["Electrophysiological signs and the prevalence of adverse effects of acetylcholinesterase inhibitors in patients with myasthenia gravis"],"prefix":"10.1002","volume":"37","author":[{"given":"Anna Rostedt","family":"Punga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikio","family":"Sawada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erik V.","family":"St\u00e5lberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2007,12,10]]},"reference":[{"key":"e_1_2_7_2_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.46.10.929"},{"key":"e_1_2_7_3_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.1998.tb11015.x"},{"key":"e_1_2_7_4_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.39.4.561"},{"key":"e_1_2_7_5_2","first-page":"1102","article-title":"Side effects of low\u2010dose pyridostigmine bromide are not related to cholinesterase inhibition","volume":"72","author":"Cook MR","year":"2001","journal-title":"Aviat Space Environ Med"},{"key":"e_1_2_7_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00213-002-1074-6"},{"key":"e_1_2_7_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/B978-0-7506-0271-6.50044-9"},{"key":"e_1_2_7_8_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.23.12.1273"},{"key":"e_1_2_7_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awg223"},{"key":"e_1_2_7_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.880050307"},{"key":"e_1_2_7_11_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.55.1.16"},{"key":"e_1_2_7_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.41.5.394"},{"key":"e_1_2_7_13_2","doi-asserted-by":"publisher","DOI":"10.1085\/jgp.53.1.70"},{"key":"e_1_2_7_14_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2003-40755"},{"key":"e_1_2_7_15_2","doi-asserted-by":"publisher","DOI":"10.1002\/mus.20515"},{"key":"e_1_2_7_16_2","series-title":"Clinical neurophysiology of disorders of muscle and neuromuscular junction, including fatigue","first-page":"507","author":"Sanders D","year":"2003"},{"key":"e_1_2_7_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.LAB.0000028144.48023.9B"},{"key":"e_1_2_7_18_2","volume-title":"Single fiber electromyography in healthy and diseased muscle","author":"St\u00e5lberg E","year":"1994"},{"key":"e_1_2_7_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4598(199609)19:9<1127::AID-MUS7>3.0.CO;2-1"},{"key":"e_1_2_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0009-8981(99)00144-8"}],"container-title":["Muscle &amp; Nerve"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fmus.20935","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mus.20935","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,10]],"date-time":"2023-10-10T04:10:42Z","timestamp":1696911042000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/mus.20935"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,12,10]]},"references-count":19,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2008,3]]}},"alternative-id":["10.1002\/mus.20935"],"URL":"https:\/\/doi.org\/10.1002\/mus.20935","archive":["Portico"],"relation":{},"ISSN":["0148-639X","1097-4598"],"issn-type":[{"value":"0148-639X","type":"print"},{"value":"1097-4598","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,12,10]]}}}