Dysphagia as a Presenting Symptom of  Myasthenia Gravis—Case Report

Ramalho, Sara; Pereira, Sandra; Oliveira, Pedro Dantas; Morais, H.; Lima, Nuno Barros; Condé, Artur

doi:10.4236/ijohns.2014.31005

Cited by 4 publications

(5 citation statements)

References 7 publications

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“…The disorder underlying this disease is the presence of antibodies that attack the nicotinic receptors in the neuromuscular junction. 2,5 The prevalence of MG is about 20 cases per 100,000 lives. The highest incidence occurs in women over 40 years and even higher in men over 50 years.…”

Section: Discussionmentioning

confidence: 99%

“…The highest incidence occurs in women over 40 years and even higher in men over 50 years. 2 The typical clinical feature of MG is fluctuating muscle weakness, especially after activity. The weaknesses include weakness of the eye and facial muscles, namely ptosis, diplopia and facial muscle weakness.…”

Section: Discussionmentioning

confidence: 99%

“…Risk factors for dysphagia are old age, gastric acid reflux, stroke, head and neck malignancy, head trauma, Parkinson's disease, multiple sclerosis, muscular dystrophy, and myasthenia gravis (MG). 1,2 Myasthenia gravis is a rare autoimmune disease that causes muscle weakness. The disorder underlying this disease is the presence of antibodies that attack the nicotinic receptors in the neuromuscular junction.…”

Section: Introductionmentioning

confidence: 99%

“…It can be a single symptom or as a accompanying symptom. Only 6% cases manifested dysphagia as a single symptom of MG. 2 Patients with dysphagia due to MG need appropriate management involving multidisciplinary approach in order to obtain a optimal result. 2,5,6 Assessment of dysphagia includes the existence of impaired swallowing function, the level of anatomy involved, and the underlying disease.…”

Section: Introductionmentioning

confidence: 99%

“…Only 6% cases manifested dysphagia as a single symptom of MG. 2 Patients with dysphagia due to MG need appropriate management involving multidisciplinary approach in order to obtain a optimal result. 2,5,6 Assessment of dysphagia includes the existence of impaired swallowing function, the level of anatomy involved, and the underlying disease. Management of MG has several therapeutic modalities that can be given based on the severity and onset of MG. 7 The purpose of this paper was to report two cases of dysphagia in MG and their management using multidisciplinary approach.…”

Section: Introductionmentioning

confidence: 99%

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Dysphagia as presenting symptom of myasthenia gravis : a case series of successful outcome in multidisciplinary approach

2020

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Dysphagia can be caused by mechanic or neurologic disorders. Neurologic dysphagia is commonly related to cerebrovascular disease, parkinson disease, amyotropic lateral sclerosis, tardive dyskinesia, and myasthenia gravis (MG). About 15-40% dysphagia occurred in MG generalized type. Only 6% MG with dysphagia were reported as a single symptom. The case reports aimed to demonstrate the role of otolaryngologist in multidisciplinary approach of the MG management. Two cases of MG were reported. First case was a 33 years old woman with moderate MG generalized type with ocular, dysphagia, and disarthria symptoms and second case was a 46 years old man with acute severe MG with crisis. Management therapy was applied according to onset and severity of MG. Acetylcholinesterase (AChE) and corticosteroid were administered for the first case, whereas therapeutic plasma exchange (TPE) for second case. In conclusion, disfagia in MG can be accompanied with other symptom, therefore its management should be based on the severity in order to give a positive result. ABSTRAK Disfagia dapat disebabkan oleh gangguan mekanik maupun motorik. Disfagia akibata gangguan saraf umumnya dikaitkan dengan penyakit cerebrovaskuler, parkinson, amyotropic lateral sclerosis, tardive dyskinesia dan miastenia gravis (MG). Sekitar 15-40% disfagia terjadi pada MG tipe generalisata. Hanya 6% disfagia dilaporkan sebagai gejala tunggal pada MG. Laporan kasus ini bertujuan memberikan gambaran peran ahli THT dalam penatalaksanaan MG secara multidisiplin. Dua kasus disfagia akibat MG telah dilaporkan. Kasus pertama adalah wanita berumur 33 tahun dengan MG tipe generalisata derajat sedang dengan gejala ocular, disfagia dan disartria. Kasus kedua seorang seorang pria berumur 46 tahun dengan MG akut berat dengan krisis. Penatalaksanaan terapi dilakukan menurut onset dan keparahan MG. Asetilkolinesterase (AChE) dan kortikosteroid diberikan untuk kasus pertama, sedangkan terapi pertukaran plasma (TPP) untuk kasus kedua. Dapat disimpulkan, disfagia pada MG dapat desertai gejala lain sehingga tatalaksananya harus diberikan sesuai derajat keparahan penyakit agar memberikan respon yang baik.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Dysphagia as presenting symptom of myasthenia gravis : a case series of successful outcome in multidisciplinary approach

2020

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Unusual Presentation of Myasthenia Crisis Following Thymectomy and Thyroidectomy

Daud

Baki

Azman

et al. 2017

Indian J Otolaryngol Head Neck Surg

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Dysphagia in myasthenia gravis: the tip of the Iceberg

Umay

Karaahmet²,

Gürçay

et al. 2018

Acta Neurol Belg

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We evaluated swallowing function in patients with myasthenia gravis (MG) with or without dysphagia symptoms using different evaluation parameters and compared the results with those of healthy subjects. A total of 36 patients with MG and 25 healthy volunteers were included in the study. The subjects were classified into three groups; patients without dysphagia (group 1), patients with dysphagia (group 2), and healthy participants (group 3). The presence and severity of dysphagia, the oropharyngeal, pharyngeal, pharyngoesophageal, and esophageal phases were assessed using a screening test, manometric test, electrophysiologic studies [electroneuromyography (EMG)], fiberoptic endoscopic evaluation of swallowing (FEES), and barium swallow pharyngeal esophagography (BSPE), respectively. There was a significant difference between group 1 and group 3 in terms of BSPE (p = 0.001) and manometry tests (p = 0.001). A significant difference was found in all methods between group 2 and group 3 (p = 0.001, for all). In the comparison of the patient groups, although the number of patients with dysphagia in group 2 was significantly higher in the clinical tests (p = 0.007), FEES (p = 0.001), and EMG (p = 0.043) than in group 1, no difference was detected for BSPE (p = 0.119) and manometry (p = 0.644). Swallowing functions in patients with MG may be affected even without symptoms. This condition should be considered in their follow-up.

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Dysphagia as a Presenting Symptom of Myasthenia Gravis—Case Report

Cited by 4 publications

References 7 publications

Dysphagia as presenting symptom of myasthenia gravis : a case series of successful outcome in multidisciplinary approach

Dysphagia as presenting symptom of myasthenia gravis : a case series of successful outcome in multidisciplinary approach

Unusual Presentation of Myasthenia Crisis Following Thymectomy and Thyroidectomy

Dysphagia in myasthenia gravis: the tip of the Iceberg

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