Head‐drop: A frequent feature of late‐onset myasthenia gravis

Sih, Marvin; Soliven, Betty; Mathenia, Nicholas; Jacobsen, John R.; Rezania, Kourosh

doi:10.1002/mus.25526

Cited by 23 publications

(15 citation statements)

References 29 publications

(32 reference statements)

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“…The diagnosis of myasthenia gravis is established by the presence of specific autoantibodies and related symptoms . Ocular symptoms are the most common symptoms, and greater than 50% of patients present with ptosis or diplopia, but the neck and limb muscles can also be involved . Respiratory muscle weakness is considered the most fatal symptom among the reported symptoms of myasthenia gravis …”

Section: Discussionmentioning

confidence: 99%

Myasthenia gravis and myopathy after nivolumab treatment for non‐small cell lung carcinoma: A case report

et al. 2019

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Here, we report a case of myasthenia gravis and myopathy in a patient treated with nivolumab. A 76‐year‐old man who had been treated with four doses of nivolumab because of non‐small cell lung cancer (NSCLC) presented with proximal‐dominant muscle weakness and fluctuating ptosis and diplopia. Serologic studies revealed increased levels of muscle enzymes including creatine phosphokinase (2934 U/L), and acetylcholine receptor antibody was positive (1.31 nmol/L). Following electrodiagnostic study, he was diagnosed with myasthenia gravis and active stage of myopathy. After discontinuation of nivolumab, he was treated with corticosteroids, intravenous immunoglobulin G, and pyridostigmine. The neuromuscular symptoms and serologic abnormalities of the patient markedly improved. Currently, he is taking oral steroids and pyridostigmine without further immunotherapy.

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Section: Discussionmentioning

confidence: 99%

Myasthenia gravis and myopathy after nivolumab treatment for non‐small cell lung carcinoma: A case report

et al. 2019

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“…It can be associated with or contribute to respiratory muscle weakness. Dropped head can be the presenting sign of only sign of MG. One retrospective study, 35 including 146 patients with generalized MG showed 15 patients (10%) of the patients developed head drop. Of these 15 patients, acetylcholine receptor binding antibodies (AchR Ab) were positive in 14, and anti- MuSK antibodies positive in 1.…”

Section: Dhs In Neuromuscular Junction Disordersmentioning

confidence: 99%

“…Of these 15 patients, acetylcholine receptor binding antibodies (AchR Ab) were positive in 14, and anti- MuSK antibodies positive in 1. 35 Dropped head symptoms in MG patients with positive AchR Ab improved with treatments, but the patient with positive anti-MuSK Ab was refractory to multi treatments including prednisone, plasmapheresis, and mycophenolate mofetil. Shortcoming of the study was no imaging, EMG or muscle biopsies findings were reported.…”

Section: Dhs In Neuromuscular Junction Disordersmentioning

confidence: 99%

Dropped head syndrome due to neuromuscular disease: clinical manifestation and evaluation

2019

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In this article, we discuss the clinical approach to patients with dropped head syndrome and identify the various neuromuscular causes of dropped head syndrome, including muscle, neuromuscular junction, peripheral nerve, and motor neuron etiologies. We aim to increase awareness and recognition of the entity of dropped head syndrome and factors that may predict responses to immunomodulating therapy.

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“…La diplopía es la forma de inicio en el 50% de los pacientes [14]. Otros síntomas son disfagia o fatiga al masticar, voz nasal, ptosis palpebral, debilidad muscular proximal, pérdida de la sonrisa y cabeza caída [15]. Los reflejos osteotendinosos son normales y nunca se compromete la pupila [16].…”

Section: Miastenia Gravisunclassified

Qué pensar antes de decir que el paciente tiene un diagnóstico psiquiátrico. Parte I

Giraldo¹,

Marín-Medina

Arias-Jaramillo³

et al. 2019

Rev. Médica Risaralda

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Los pacientes refieren sus síntomas en una gran variedad de términos como: "estoy cansado", "me duelen las articulaciones", "me pica todo el cuerpo", "tengo la boca seca", entre otros. Ante estos síntomas el médico piensa de manera automática en un número limitado de patologías que le son familiares, pero existen muchas otras causas a estos síntomas que no se tienen en cuenta. El desconocimiento del médico hace que en el paciente se genere inconformidad al no tenerse un diagnóstico correcto y un tratamiento adecuado, esto lleva a múltiples consultas y que el médico llegue a preguntarse a sí mismo “¿será que este paciente tiene un diagnóstico psiquiátrico?”. En este artículo se enumeran las causas frecuentes de estos síntomas mencionados, se describen causas que son pocas veces sospechadas y las claves clínicas para que el médico pueda hacer el diagnóstico de éstas. La primera parte desarrollará los síntomas: fatiga, parestesias, prurito, artralgias, ansiedad y cambios en el comportamiento. La segunda parte desarrollará los síntomas: intolerancia a los alimentos, xerostomía, síncope, disfagia y manifestaciones en pacientes con cirugía bariátrica.

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Head‐drop: A frequent feature of late‐onset myasthenia gravis

Abstract: Head-drop is a common, treatment-responsive manifestation of late-onset MG. Muscle Nerve 56: 441-444, 2017.

Cited by 23 publications

References 29 publications

Myasthenia gravis and myopathy after nivolumab treatment for non‐small cell lung carcinoma: A case report

Myasthenia gravis and myopathy after nivolumab treatment for non‐small cell lung carcinoma: A case report

Dropped head syndrome due to neuromuscular disease: clinical manifestation and evaluation

Qué pensar antes de decir que el paciente tiene un diagnóstico psiquiátrico. Parte I

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