1/33. Bilateral abductor vocal fold paralysis due to myasthenia gravis.We report a case of bilateral abductor vocal fold paralysis due to myasthenia gravis in a 61-year-old man who presented with stridor requiring tracheostomy. The stridor had been preceded by several weeks' history of diplopia.- - - - - - - - - - ranking = 1keywords = myasthenia gravis, myasthenia, gravis (Clic here for more details about this article) |
2/33. Can myasthenia gravis be diagnosed with the 'ice pack test'? A cautionary note.The ice pack test may be helpful in establishing that ptosis is due to ocular myasthenia gravis, since cold improves neuromuscular transmission. However, the role of the test in determining whether diplopia is of myasthenic origin has yet to be established.- - - - - - - - - - ranking = 1keywords = myasthenia gravis, myasthenia, gravis (Clic here for more details about this article) |
3/33. myasthenia gravis with a paraneoplastic marker.Ocular manifestations of myasthenia gravis are very common. myasthenia gravis may be associated with lung carcinoma. Lambert-Eaton syndrome is also commonly associated with lung carcinoma and can have ocular manifestations. Overlap of these two entities has been described. The case of a patient with fatigable diplopia and ptosis 3 years after removal of a large-cell lung carcinoma is presented. Tests results for acetylcholine receptor binding and modulating antibodies were positive for myasthenia gravis. Test results for presynaptic voltage-gated calcium channel antibodies of the N-type were also positive. However, test results for the P/Q-type voltage-gated calcium channel antibodies, which are consistent with Lambert-Eaton syndrome, were negative. autoantibodies can be used to serologically distinguish paraneoplastic myasthenia gravis from Lambert-Eaton syndrome.- - - - - - - - - - ranking = 0.68076067047983keywords = myasthenia gravis, myasthenia, gravis (Clic here for more details about this article) |
4/33. Ocular myasthenia and nitrofurantoin.PURPOSE: To report a case of ocular myasthenia associated with administration of nitrofurantoin. methods: Case report and review of the literature. RESULTS: While taking nitrofurantoin after urinary tract surgery, a 10-year-old female developed diplopia and ptosis. sleep test confirmed ocular myasthenia. signs and symptoms resolved after discontinuation of the drug. CONCLUSION: Ocular myasthenia may be associated with nitrofurantoin administration.- - - - - - - - - - ranking = 0.39212831213907keywords = myasthenia (Clic here for more details about this article) |
5/33. Bulbar presentations of myasthenia gravis in the elderly patient.We report on three cases of patients whose primary symptoms of myasthenia gravis were related to the upper aerodigestive tract. Symptoms had been present unrecognized in all patients for up to three years, and one patient subsequently developed a myasthenic crisis. We highlight the clinical features of myasthenia gravis to allow its prompt recognition in patients presenting to the ENT surgeon or physician.- - - - - - - - - - ranking = 1.2keywords = myasthenia gravis, myasthenia, gravis (Clic here for more details about this article) |
6/33. Surgical correction of blepharoptosis in patients with myasthenia gravis.PURPOSE: To describe the results of surgical correction of blepharoptosis in a series of patients with myasthenia gravis (MG). methods: In this retrospective case series, we reviewed the medical records of all patients with MG who did not respond to medical therapy and underwent surgical correction for blepharoptosis at the Mayo Clinic between 1985 and 1999. The primary outcome measure was change in interpalpebral eyelid fissure height. RESULTS: Sixteen blepharoptosis procedures were performed on 10 patients with MG. Eight of the 10 patients had ocular MG. Two of the 10 patients had systemic MG. Of the 16 procedures performed, 9 were external levator advancements (ELA), six were frontalis slings, and one was a tarsomyectomy. patients were followed postoperatively for an average of 34 months (range, 14-126 months). The amount of ptosis was quantified pre- and postoperatively for seven of the nine eyelids that underwent ELA. For these seven eyelids (five patients), there was a statistically significant improvement in the mean interpalpebral eyelid fissure height from 3.7 mm preoperatively to 7.8 mm postoperatively, with a mean difference of 4.1 mm (95% confidence interval 1.9 mm to 6.25 mm, p = 0.0038). postoperative complications included worsened diplopia in one patient with ELA and exposure keratopathy in one patient with frontalis sling. Two of the ELA eyelids developed recurrent ptosis requiring additional surgery more than 2 years after the initial procedure. CONCLUSIONS: blepharoptosis surgery can achieve eyelid elevation in patients who have failed to respond to medical therapy for MG. Potential complications include worsened diplopia and exposure keratopathy.- - - - - - - - - - ranking = 1keywords = myasthenia gravis, myasthenia, gravis (Clic here for more details about this article) |
7/33. Active management in patients with ocular manifestations of myasthenia gravis.PURPOSE: myasthenia gravis can cause variable strabismus with disabling diplopia and/or poor cosmesis. A retrospective study of a group of patients with myasthenia gravis or 'myasthenia gravis like' syndromes was made. methods: The study group consisted of patients who had undergone botulinum toxin treatment and/or surgery for disabling diplopia, poor cosmesis or both. Surgical treatment was by conventional techniques including recess/resect, posterior fixation, superior oblique tenotomy and adjustable sutures. RESULTS: There were 9 patients in the study group (8 female, 1 male). Age at surgery ranged from 21 to 59 years (mean 46 years). Six were symptom-free following treatment. Two, although symptomatically improved, had occasional diplopia. One patient failed treatment and required an occlusive contact lens. CONCLUSIONS: The ocular manifestations of myasthenia gravis or 'myasthenia gravis like' syndromes may respond to surgery and/or botulinum toxin injection. Active intervention should be considered when deviations become stable. To our knowledge this is the first report of the use of botulinum toxin in such patients.- - - - - - - - - - ranking = 1.616152134096keywords = myasthenia gravis, myasthenia, gravis (Clic here for more details about this article) |
8/33. myasthenia gravis presenting as a unilateral abducens nerve palsy.A 48-year-old man with no significant medical history presented to the emergency department of a large, urban, tertiary-care hospital complaining of double vision and unsteady gait. physical examination was remarkable for an isolated, unilateral sixth nerve palsy. After comprehensive testing, a final diagnosis of myasthenia gravis was made. The patient's unsteady gait was a manifestation of sensory distortion from the diplopia and corrected when the patient closed his eyes. The presentation of myasthenia gravis as an isolated sixth nerve palsy is unprecedented in the emergency medicine literature.- - - - - - - - - - ranking = 0.46460853638386keywords = myasthenia gravis, myasthenia, gravis (Clic here for more details about this article) |
9/33. Respiratory chain complex-I defect mimicking myasthenia.In a 67-year-old woman with ptosis, double vision, dysphagia, ambiguous Tensilon tests, normal acetylcholine-receptor antibodies, normal thymus, and repeatedly abnormal responses to low-frequency repetitive stimulation, ocular myasthenia was suspected. Pyridostigmin was ineffective, but corticosteroids improved the abnormalities. Despite this therapy, lower-limb weakness developed. Reevaluation disclosed abnormal increase of serum lactate during slight exercise, myogenic electromyography, ragged-red fibers, reduced oxidative enzyme staining and abnormally shaped and structured mitochondria on muscle biopsy, and a respiratory chain complex-I defect on biochemical investigation of the muscle homogenate. Respiratory chain disorder due to complex-I defect with abnormal decremental response to low-frequency repetitive stimulation was diagnosed. It is concluded that respiratory chain disorders due to a complex-I defect may mimic ocular myasthenia clinically, electrophysiologically, and even therapeutically.- - - - - - - - - - ranking = 0.33610998183349keywords = myasthenia (Clic here for more details about this article) |
10/33. Ocular neuromyotonia: a case report.Ocular neuromyotonia is a rare motility disorder occurring after tumor irradiation near the skull base or as a consequence of vascular abnormalities. Ocular myasthenia, convergence spasm and a cyclic third nerve palsy must be considered as differential diagnoses. The case of a 32-year-old woman suffering from intermittent diplopia six months after radiation therapy of a recurrent pituary gland adenoma is presented.- - - - - - - - - - ranking = 0.056018330305581keywords = myasthenia (Clic here for more details about this article) |
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