Why in myasthenia pain gets worse troughout day while it improves with use in Lambert?

[Jonathanwillgetit]

i just don't get it

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[Northerncardinal]

In myasthinia, the nicotinic Ach receptors become desensitized with time. And the central pain attenuating pathways cannot have an impact on downstream pain sensing pathways in the spinal cord. I think that's why pain perception increases in myasthenia pts.

Regarding Lambert eaton, As time goes by, more and more neurotransmitter vesicles accumulate at the nerve terminal, hence, even an small stimulus would cause more release of Ach with time ---> improvement of movements (and perhaps pain attenuating pathways) with time.