Fatigue pp 83-100 | Cite as

Fatigue at the Neuromuscular Junction

Branch Point vs. Presynaptic vs. Postsynaptic Mechanisms
  • G. C. Sieck
  • Y. S. Prakash
Part of the Advances in Experimental Medicine and Biology book series (AEMB, volume 384)


There are several pre- and postsynaptic sites where neuromuscular transmission failure (NTF) can occur, leading to peripheral muscle fatigue. Presynaptic sites of NTF include: axonal branch point conduction block; a failure of excitation-secretion coupling at the presynaptic terminal; reductions in quantal release of ACh; and reductions in quantal size. Postsynaptic sites of NTF include: cholinergic receptor desensitization; and reduced sarcolemmal excitability. Susceptibility to NTF increases with stimulation frequency and is most prevalent in fatigable fast-twitch motor units. In addition, susceptibility to NTF varies with age and with conditions of altered use.


Motor Unit Neuromuscular Junction Neuromuscular Transmission MEPP Amplitude Repetitive Stimulation 
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Copyright information

© Springer Science+Business Media New York 1995

Authors and Affiliations

  • G. C. Sieck
    • 1
  • Y. S. Prakash
    • 1
  1. 1.Departments of Anesthesiology and Physiology and BiophysicsMayo Clinic and FoundationRochesterUSA

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