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Bulbar myasthenia gravis superimposed in a medullary infarction diagnosed by a fiberoptic endoscopic evaluation of swallowing with simultaneous tensilon application

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Author(s)
Dong-Gyun SohnSae-Rom KangSun ImSung-Jun KimGeun-Young ParkYong-Min Choi
Keimyung Author(s)
Choi, Yong Min
Department
Dept. of Rehabilitation Medicine (재활의학)
Journal Title
Annals of Rehabilitation Medicine
Issued Date
2017
Volume
41
Issue
6
Keyword
EdrophoniumMyasthenia gravisStroke
Abstract
In the elderly, myasthenia gravis (MG) can present with bulbar symptoms, which can be clinically difficult to diagnose from other neurological comorbid conditions. We describe a case of a 75-year-old man who had been previously diagnosed with dysphagia associated with medullary infarction but exhibited aggravation of the dysphagia later on due to a superimposed development of bulbar MG. After recovering from his initial swallowing difficulties, the patient suddenly developed ptosis, drooling, and generalized weakness with aggravated dysphagia. Two follow-up brain magnetic resonance imaging (MRI) scans displayed no new brain lesions. Antibodies to acetylcholine receptor and muscle-specific kinase were negative. Subsequent electrodiagnosis with repetitive nerve stimulation tests revealed unremarkable findings. A diagnosis of bulbar MG could only be established after fiberoptic endoscopic evaluation of swallowing (FEES) with simultaneous Tensilon application. After application of intravenous pyridostigmine, significant improvement in dysphagia and ptosis were observed both clinically and according to the FEES.
Keimyung Author(s)(Kor)
최용민
Publisher
School of Medicine (의과대학)
Citation
Dong-Gyun Sohn et al. (2017). Bulbar myasthenia gravis superimposed in a medullary infarction diagnosed by a fiberoptic endoscopic evaluation of swallowing with simultaneous tensilon application. Annals of Rehabilitation Medicine, 41(6), 1082–1087. doi: 10.5535/arm.2017.41.6.1082
Type
Article
ISSN
2234-0645
DOI
10.5535/arm.2017.41.6.1082
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41102
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Rehabilitation Medicine (재활의학)
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