Myasthenia Gravis and preserved deep tendon reflexes, why?

[mmmcdowe]

Hey all,

I saw a patient on rounds the other day w/ MG and it was mentioned that DTR are preserved. I've been going over it in my head and I am confused why they would be preserved across the board. Is it just because of the extent of muscle contraction needed for a reflex versus full muscle usage? I'd love you forever for a reference!

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[reedman]

maybe the deep tendon reflexes are the last to go, and it just hasn't got that bad?

 

[pinkes]

Muscle reflex do require Ach so It is affected in MG...If you constantly do DTR then U will realize decreased response...

While DTR in patients with Lambert Eaton Myasthenic Syndrome: intially absent but with constant stimulation U will see response....a good sign to differentiate MG vs LEMs....