[The comparison of selected spirometric parameters with functional muscles exercise evaluation in patients with myasthenia]. / Porównanie wybranych parametrów spirometrycznych z funkcjonalna ocena wysilkowa miesni u chorych na miastenie.

UNLABELLED: Pathological skeletal muscle weakness is an axial clinical symptom of myasthenia (MG). Diminished respiratory muscular force can be manifested by decreased peak expiratory flow (PEF) value. MATERIAL AND METHODS: Patients aged 13-77 years were studied at which according to Osserman classification ocular form (the type I) or generalized form (the type II) was diagnosed (n = 68). PEF and FVC values such as % of predicted value (PV) obtained in "flow-volume" measure were analysed. The trunk and extremities muscles force was estimated according to Besinger. RESULTS: Weakness of lower extremities muscles was found at all examined subjects. Positive result of trunk muscle test was found in 69% of patients with type I and 89% with type II. In type II upper extremities muscles (UEM) weakness was observed more often than in type I (74% subjects vs. 31%). In both types of MG the mean value of PEF was lower in patients with UEM weakness and amounted 89.5% vs. 112.4% in type I and 87.4% vs. 100.4% in type II. In type I the mean value of FVC was lower in patients with UEM weakness than in patients without symptoms (83.7% vs. 106.2%), with trunk muscles weakness (93.8% vs. 111.7%) and in patients with decreased muscles force up to 15% (87.5% vs. 106.7%). In this type of MG decreased value of FVC < 80% PV was observed in 50% of patients with UEM weakness and in 40% of patients with decreased muscles force up to 15%, but at none of subjects without symptoms in above tests. CONCLUSIONS: In patients with myasthenia of type I and II the weakness of upper extremities muscles correlates with decreased PEF value in spirometry. In addition in ocular myasthenia decreased FVC value was observed more often in patients with positive results of test of the functional muscles estimation.

[Spirometric evaluation of lung function in patients with myasthenia]. / Spirometryczna ocena funkcji pluc u chorych na miastenie.

UNLABELLED: Effort dyspnoea or dyspnoea at rest are predominating among subjective complaints in patients with myasthenia (myasthenia gravis--MG). THE AIM of the study was to evaluate the airway function in patients with MG by means of the chosen spirometric parameters analysis. MATERIAL AND METHODS: We observed 68 patients with MG in which type I (the ocular myasthenia), type IIA (the mild generalized form), type IIB (the subacute generalized form) and type IIC (the acute generalized form) was diagnosed based on Osserman classification and on 20 healthy volunteers (control group--CG). The function of the airways was assessed by means of "flow-volume" spirometry. RESULTS: The mean values of FEV1, MEF25-75 i FVC in the type II MG were lower than in CG. The mean value of PEF in the type II was lower than in CG and lower than in type I. In the type I of MG the mean values of evaluated parameters were not different than in CG. Decrease of PEF value was the most often found. The frequency of decreased PEF and FEV1 values was higher in type II than in CG. In all types of generalized MG the reduced FVC was found more frequently than in healthy people. In each types of MG (the type IIA, IIB, IIC) the mean values of the estimated parameters and the frequency of the deviation from predicted values were not different. CONCLUSION: The results show that in type II of MG the decrease of spirometric parameters is observed more often than in healthy people and these abnormalities are most marked in PEF. In the ocular MG the distinct tendency to FVC decrease is observed.