Epidemiologic studies of myasthenia gravis: literature review

BACKGROUND: Myasthenia gravis is a rare autoimmune disease,which is difficult to diagnose mainly in the initial stages, when there are single symptoms of the disease or an atypical course. Diagnostic errors are associated with the fact that myasthenia gravis and other diseases of the nervous system have similar symptoms. The most common misdiagnosis in the onset of myasthenia gravis is a stroke. However, the reasons for a false diagnosis remain unspecified and poorly understood. AIM: To determine the factors leading to misdiagnosis of a stroke in the onset of myasthenia gravis. MATERIALS AND METHODS: 133 patients diagnosed with myasthenia gravis were divided into two groups. Patients with misdiagnosed stroke at the onset of myasthenia gravis formed the first group, the rest of the patients – the second group. A comparative assessment was performed according to the age of myasthenia onset, the clinical variant of the onset, primary symptoms, the duration of diagnosis, and the severity of the disease at the time of the correct diagnosis, with the percentage of misdiagnosis calculation. RESULTS: Stroke as misdiagnosis was established more often than others (in 23% of all cases and in 44% of incorrect diagnoses). In the 1st group, complaints of dysarthria and dysphagia were significantly higher, myasthenia gravis began acutely more often, the age of myasthenia onset in patients of the 1st group was statistically higher than in the 2nd. There was no difference between the groups in terms of diagnosis duration, the disease severity, and the history of previous stroke. CONCLUSIONS: Factors leading to stroke misdiagnosis at the onset of myasthenia are advanced age and acute onset with bulbar disorders.

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The relationship of cognitive impairment and clinical manifestations of myasthenia gravis

Alibekov

Голдобин

Yuldashev

et al. 2023

Neurology bulletin

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BACKGROUND. There are many studies in the literature suggesting that cognitive impairment is more pronounced in patients with myasthenia gravis compared with healthy people, but there is no explanation of the reasons and mechanisms. However, the reverse character the influence of intellectual-mnestic disorders on the course of myasthenia gravis has not been studied enough. AIM. To compare clinical, anamnestiс, laboratory and instrumental data in patients with myasthenia gravis according to the presence or absence of cognitive impairment. MATERIAL AND METHODS. 61 patients with a confirmed diagnosis of myasthenia gravis were divided into 2 groups according to the Montreal cognitive test. Patients scoring 25 or less were assigned to the first group, those scoring 26 points or more to the second group. A comparative assessment was made according to the myasthenia gravis impairment index, age of onset, duration of the disease, duration of hospitalization, severity of myasthenia gravis according to clinical scales, body mass index, electroneuromyography data, levels of antibodies to the acetylcholine receptor and skeletal muscles, and daily doses of the drugs received. RESULTS. In the 1st group, there was a significantly higher score on the Generalised Disorders subscale of the Myasthenia Gravis Impairment Index; the severity of Quantitative myasthenia gravis score was significantly higher in the 1st group than in the 2nd both for the total score and for the Musculoskeletal Lesions subscale. On average, 49 mg more pyridostigmine bromide was required in the first group, while the average body mass index was significantly lower in the first group. CONCLUSION. The presence of a cognitive deficit in patients with myasthenia gravis may worsen the clinical picture of the disease, which should be taken into account by clinicians, especially in elderly patients, who are at increased risk of developing cognitive disorders.

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Epidemiologic studies of myasthenia gravis: literature review

Cited by 6 publications

References 15 publications

Cross-syndrome: myasthenia gravis and the demyelinating diseases of the central nervous system combination. Systematic literature review and case reports

Cross-syndrome: myasthenia gravis and the demyelinating diseases of the central nervous system combination. Systematic literature review and case reports

Factors of stroke misdiagnosis at the onset of myastenia gravis

The relationship of cognitive impairment and clinical manifestations of myasthenia gravis

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