Cases reported "Fasciculation"

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1/4. myasthenia gravis--a rare presentation with tongue atrophy and fasciculation.

    We report the case of an unusual presentation of myasthenia gravis with tongue atrophy and fasciculation. myasthenia gravis is an autoimmune condition associated with weakness and fatigability of voluntary muscles. In >50%, the initial symptoms and signs are related to extraocular muscle weakness, such as diplopia or ptosis [Tsung K, Seggev JS. An unusual cause of dysphagia. West J Med 1995; 163: 159-60]. Rarely, it is known to affect bulbar muscles and can lead to dysphagia and respiratory compromise.
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2/4. myokymia of the tongue in a case of brainstem tumour that simulated motor-neuron disease.

    The diagnosis of a brainstem tumour, which presented as progressive bulbar palsy that resembled motor-neuron disease, was suspected because of the rare electromyographic finding of myokymia of the tongue, and was confirmed by magnetic resonance imaging.
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3/4. myokymia and neuromyotonia of the tongue: a case report of complication of irradiation.

    A 51-year-old man has suffered from progressive dysarthria since 1989. He himself noted slight weakness and tightness of the tongue, so that he was unable to perform motor tasks in a normal fashion. He was diagnosed as having nasopharyngeal carcinoma and had irradiation 70 Gy in 32 divided doses in 1979. Neurological examination revealed left-sided tongue atrophy and myokymia sparing of facial muscles involvement. Electrical discharges of myokymia and neuromyotonia were observed in the tongue muscles, suggesting hypoglossal nerve lesion with hyperexcitability of the axon membrance. Computed tomogram of brain did not show any evidence of recurrence of tumor; indicating that irradiation was the pathologic basis. Our report revealed that myokymia and neuromyotonia of the tongue was an unusual complication of irradiation.
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4/4. Myokymic discharges of the tongue after radiation to the head and neck.

    We report two patients who developed myokymic discharges of the tongue after radiation therapy. One patient had carcinoma of the nasopharynx, and the other had a chemodectoma of the middle ear. radiation therapy may damage the hypoglossal nerve and cause myokymia of the tongue, similar to myokymic discharges associated with brachial plexopathies after radiation therapy.
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