Mysterious falls and a nasal voice

Fracture rate in patients with myasthenia gravis: the general practice research database

“…Despite associations of MG with falling [5–7] and with glucocorticoid-induced osteoporosis [8, 9], our findings showed no significantly increased risk of fracture. In contrast, our finding of an increased risk of fracture in users of various classes of CNS drugs is in keeping with previous findings [18–21, 34].…”

“…MG is associated with an increased falls risk [5–7] and glucocorticoid-induced osteoporosis [8, 9]. The increased risk of falls from MG is likely to be multifactorial including severe muscle weakness [1], impaired vision as a result of ocular MG and steroid-induced myopathy [10, 11].…”

Clinical features of patients with Myasthenia gravis from the Henan province, China

“…Myasthenia gravis (MG) is an autoimmune disease characterized by painless fluctuating weakness and a propensity for skeletal muscle fatigue, often beginning with ocular symptoms, such as ptosis and diplopia . The incidence of MG varies between 1 and 2 and 5 and 15 per 100,000 population . The distribution is bimodal, with more women being affected among patients aged <40 years, and more men among patients aged >50 years .…”

“…1 The incidence of MG varies between 1 and 2 and 5 and 15 per 100,000 population. 1,2 The distribution is bimodal, with more women being affected among patients aged <40 years, and more men among patients aged >50 years. 1 The symptoms are due to destruction of postsynaptic membranes and to reduction of acetylcholine receptors (AChRs) at neuromuscular junctions caused by an autoantibody directed against the AChR (AChRab).…”

Evaluación e intervención del habla en Miastenia Gravis

“…De acuerdo con Darley, Aronson y Brown (1978), estas alteraciones corresponden a los signos de una disartria flácida, un tipo de disartria originado por lesión en algún componente de la neurona motora inferior (Duffy, 2005), más específicamente, en los nervios craneales involucrados en el habla o en los nervios espinales relacionados con el soporte respiratorio (LaPointe, Murdoch, & Stierwalt, 2010), bien sea en su origen, recorrido o unión con los músculos (Hegde & Freed, 2011). Entre las dificultades se han reportado alteraciones en la fonación caracterizadas por la presencia de voz débil al final del día (Salazar et al, 2002), cambios en el tono vocal (Liu, Xia, Men, Wu & Huang, 2007;Mao et al, 2001;Montero-Odasso, 2006 ), voz ronca (Liu et al, 2007;Mao et al, 2001;Witoonpanich et al, 2013), fatiga vocal (Liu et al, 2007;Mao et al, 2001), disminución del volumen de la voz, voz aspirada, falta de claridad vocal y afonía (Mao et al, 2001); alteraciones en la resonancia del habla, como voz hipernasal o rinolalia (Bhandari & Adenwalla, 2007;Salazar et al, 2002;Wolsky, 1967) y dificultades en la articulación como habla enredada (Cook, McParland & Escudier, 2008), habla difícil de entender o dificultad para hablar (Witoonpanich et al, 2013), disartria (Salazar et al, 2002;Shaik, Ul-Haq & Emsley, 2014) o disartria que empeora durante el día (Tremolizzo et al, 2015) así como dificultades para la producción de sonidos específicos como /r/ o /l/ (D'Alessandro, 1992).…”