Myasthenia Gravis and Hypothyroidism in a Dog With Meningomyelitis

2005 ◽  
Vol 41 (4) ◽  
pp. 247-251 ◽  
Author(s):  
Jonathan M. Levine ◽  
Robert L. Bergman ◽  
Joan R. Coates ◽  
G. Diane Shelton
Keyword(s):  
Nervous System ◽  
Myasthenia Gravis ◽  
Peripheral Nervous System ◽  
Neurological Assessment ◽  
Limb Weakness ◽  
History Of ◽  
Pelvic Limb

A 12-year-old, spayed female miniature poodle was evaluated because of a 4-day history of paraparesis, dysuria, and tenesmus. Neurological assessment suggested peripheral nervous system dysfunction, predominantly pelvic limb weakness with a possible concurrent sixth lumbar (L6) to second sacral (S2) myelopathy. Further studies supported the diagnoses of myasthenia gravis, hypothyroidism, and meningomyelitis. To the authors’ knowledge, this is the first reported case of concurrent myasthenia gravis and meningomyelitis in the dog. It was unclear whether the identified conditions evolved from a shared etiopathogenesis or were merely coincidental.

scholarly journals Peripheral Nervous System Involvement in Late-Onset Cobalamin C Disease?

2020 ◽  
Vol 11 ◽  
Author(s):  
Xujun Chu ◽  
Lingchao Meng ◽  
Wei Zhang ◽  
Jinjun Luo ◽  
Zhaoxia Wang ◽  
...  
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Methylenetetrahydrofolate Reductase ◽  
Late Onset ◽  
Hot Spot ◽  
Axonal Neuropathy ◽  
Methylmalonic Aciduria ◽  
Lower Limbs ◽  
Compound Heterozygous ◽  
Limb Weakness

Background: Cobalamin C (cblC) has a fundamental role in both central and peripheral nervous system function at any age. Neurologic manifestations may be the earliest and often the only manifestation of hereditary or acquired cblC defect. Peripheral neuropathy remains a classical but underdiagnosed complication of cblC defect, especially in late-onset cblC disease caused by mutations in the methylmalonic aciduria type C and homocysteinemia (MMACHC) gene. So the clinical, electrophysiological, and pathological characteristics of late-onset cblC disease are not well-known.Methods: A retrospective study of patients with late-onset cblC disease was conducted at our hospital on a 3-year period. The neuropathy was confirmed by the nerve conduction study. Sural biopsies were performed in 2 patients.Results: Eight patients were identified, with a mean onset age of 16.25 ± 6.07 years. All patients had methylmalonic aciduria, homocysteinemia, compound heterozygous MMACHC gene mutations were detected in all patients, and 7/8 patients with c.482G>A mutation. One patient concomitant with homozygote c.665C>T mutation in 5,10-methylenetetrahydrofolate reductase (MTHFR) gene. All patients showed limb weakness and cognitive impairment. Five patients had possible sensorimotor axonal polyneuropathy predominantly in the distal lower limbs. Sural biopsies showed loss of myelinated and unmyelinated fibers. Electro microscopy revealed crystalline-like inclusions bodies in Schwann cells and axonal degeneration.Conclusion: Late-onset cblC disease had possible heterogeneous group of distal axonal neuropathy. c.482G>A mutation is a hot spot mutation in late-onset cblC disease.

Anaesthesia considerations for a patient with suspected myasthenia gravis

2020 ◽  
Vol 11 (10) ◽  
pp. 474-479
Author(s):  
Roxanne O'Brien
Keyword(s):  
Myasthenia Gravis ◽  
Nursing Care ◽  
Neuromuscular Transmission ◽  
Case Reports ◽  
Limb Weakness ◽  
Risk Of Mortality ◽  
Immune Mediated ◽  
Pelvic Limb

This extended case reports explores the pre-, peri- and post-anaesthetic considerations in a 2-year 7-month-old male entire crossbreed with suspected myasthenia gravis after presenting with gastrointestinal signs and pelvic limb weakness. Myasthenia gravis is an immune-mediated neuromuscular transmission disorder, which greatly increases the risk of mortality in patients undergoing anaesthesia. Following specific nursing care, in this case no complications occurred and the dog went home 3 days later.

scholarly journals Factors Affecting Generalization of Ocular Myasthenia Gravis in Palembang

2021 ◽  
Vol 5 (1) ◽  
pp. 185-193
Author(s):  
Zahratul Riadho Farid ◽  
Devi Azri Wahyuni
Keyword(s):  
Myasthenia Gravis ◽  
Limb Weakness ◽  
Factors Affecting ◽  
Ocular Myasthenia ◽  
Ocular Myasthenia Gravis ◽  
Bulbar Symptoms ◽  
Levator Palpebrae ◽  
History Of ◽  
Conversion Time ◽  
Myastenia Gravis

Introduction. Ocular myasthenia gravis (OMG) is an autoimmune disease which is characterized by weakness of extraocular muscles, levator palpebrae and orbicularis oculi, resulting in ptosis and binocular diplopia. Nearly all patients present with eyelid and extra ocular muscles involvement. Approximately 30% to 80% of patients with OMG experience a conversion to generalized myasthenia gravis (GMG) within 2 years. There are not only have ptosis and diplopia but also limb weakness,bulbar symptoms, or even respiratory failure. This study was aimed to observe the clinical features of OMG to GMG and risk factors and median time to conversion of OMG to GMG of myasthenia gravis patients in Mohammad Hoesin General Hospital Palembang. Method. This study is a cohort retrospective study and the data were collected from the medical records of 91 patients who were registered as myasthenia gravis patients during September 2018 to March 2020. Sosiodemographic and clinical characteristics, including onset of OMG to GMG, history of smoking, presence of thymic abnormalities, and medications received were reviewed retrospectively. Result. A total of 91 OMG patients were observed in this study with 32 (35,2%) patients converted from ocular myastenia gravis to general myastenia gravis. Median conversion time to GMG was 34 months. Risk factor for convertion cases of OMG to MGG was receiving immunosupressive agents (Risk: 14.7, 95% CI 4.83, 44.7), thymus hyperplasia (Risk: 3.36, CI 95% 0.33, 33.6), Female (Risk: 2.41, 95% CI 0.94, 6.17), Smoking (Risk: 1.56, 95% CI 0.31, 7.81). Conclusion. Ptosis was the definitive sign for OMG in this study, with all patients had ptosis, thus it needs the colaboration from neuroophthalmologist and neurologist to diagnose and manage this case. Most of converted case was female and those who receive an immunosupressive agent therapy.

Floor of Mouth Neurofibroma: A Rare Presentation

2020 ◽  
Vol 3 (1) ◽  
Author(s):  
Stansfield J ◽  
◽  
Sharma S ◽  
Mirza O ◽  
Jayaram S ◽  
...  
Keyword(s):  
Nervous System ◽  
Oral Cavity ◽  
Peripheral Nervous System ◽  
External Approach ◽  
Rare Presentation ◽  
Floor Of Mouth ◽  
History Of ◽  
Benign Tumours ◽  
Immune Assay

Solitary sporadic neurofibromas are uncommon benign tumours of the neural sheaths of the peripheral nervous system. Solitary sporadic neurofibromas of the oral cavity and floor of mouth are extremely rare. We present the case of a 36-year-old male who presented with a 3-month history of a soft non-tender floor of mouth mass. MRI demonstrated a cystic septated lesion filling the left sublingual space. The lesion was excised via an external approach. Histology and immune assay unexpectedly demonstrated a neurofibroma.

scholarly journals Factors Affecting Generalization of Ocular Myasthenia Gravis in Palembang

2021 ◽  
Vol 3 (2) ◽  
pp. 75-84
Author(s):  
Zahratul Riadho Farid ◽  
Devi Azri Wahyuni
Keyword(s):  
Myasthenia Gravis ◽  
Limb Weakness ◽  
Factors Affecting ◽  
Ocular Myasthenia ◽  
Ocular Myasthenia Gravis ◽  
Bulbar Symptoms ◽  
Levator Palpebrae ◽  
History Of ◽  
Conversion Time ◽  
Myastenia Gravis

Introduction. Ocular myasthenia gravis (OMG) is an autoimmune disease which is characterized by weakness of extraocular muscles, levator palpebrae and orbicularis oculi, resulting in ptosis and binocular diplopia. Nearly all patients present with eyelid and extra ocular muscles involvement. Approximately 30% to 80% of patients with OMG experience a conversion to generalized myasthenia gravis (GMG) within 2 years. There are not only have ptosis and diplopia but also limb weakness,bulbar symptoms, or even respiratory failure. Objective. To observe the clinical features of OMG to GMG and risk factors and median time to conversion of OMG to GMG of myasthenia gravis patients in Mohammad Hoesin General Hospital Palembang. Method. This study is a cohort retrospective study and the data were collected from the medical records of 91 patients who were registered as myasthenia gravis patients during September 2018 to March 2020. Sosiodemographic and clinical characteristics, including onset of OMG to GMG, history of smoking, presence of thymic abnormalities, and medications received were reviewed retrospectively. Result. A total of 91 OMG patients were observed in this study with 32 (35,2%) patients converted from ocular myastenia gravis to general myastenia gravis. Median conversion time to GMG was 34 months. Risk factor for convertion cases of OMG to MGG was receiving immunosupressive agents(Risk: 14.7, 95% CI 4.83, 44.7), thymus hyperplasia (Risk: 3.36, CI 95% 0.33, 33.6), Female (Risk: 2.41, 95% CI 0.94, 6.17), Smoking (Risk: 1.56, 95% CI 0.31, 7.81). Conclusion. Ptosis was the definitive sign for OMG in this study, with all patients had ptosis, thus it needs the colaboration from neuroophthalmologist and neurologist to diagnose and manage this case. Most of converted case was female and those who receive an immunosupressive agent therapy.

scholarly journals Myasthenia Gravis—An Analysis of Multimodal Evoked Potentials

2021 ◽  
Vol 11 (8) ◽  
pp. 1057
Author(s):  
Edyta Dziadkowiak ◽  
Marta Waliszewska-Prosół ◽  
Małgorzata Wieczorek ◽  
Joanna Bladowska ◽  
Sławomir Budrewicz ◽  
...  
Keyword(s):  
Nervous System ◽  
Autoimmune Disease ◽  
Neuromuscular Junction ◽  
Myasthenia Gravis ◽  
Evoked Potentials ◽  
Peripheral Nervous System ◽  
Comprehensive Analysis ◽  
Mr Images ◽  
Multimodal Evoked Potentials

Introduction: The aim of this study is a comprehensive analysis of the parameters of exogenous evoked potentials (visual, brainstem auditory, and somatosensory) in patients with myasthenia gravis (MG), a prototype of both neuromuscular junction disease and autoimmune disease. The study also seeks to isolate electrophysiological changes that may indicate disorders within the central and/or peripheral nervous system. Methods: A total of forty-two consecutive patients with myasthenia gravis (24 women, 18 men) were included in the study. All of the patients underwent EP examination. MR images were also analyzed. Results: In the group of MG patients, the latency of P100 (113.9 ± 13.9; p < 0.0001) VEP, wave III (3.92 ± 0.29; p = 0.015), wave V (5.93 ± 0.32; <0.0001), interlatency III–V (2.00 ± 0.12; p < 0.0001), interlatency I–V (4.20 ± 0.28; p < 0.001) BAEP, and all components of SEP (N9, P10, N13, P16, N20, P22) were significantly longer. Mean wave I and V amplitude BAEP were relatively lower. Conclusions: The results of the study suggest the presence of disturbances in the bioelectric activities of the central and peripheral nervous system in MG patients.

When botany inspired pathology of the peripheral nervous system

Neurology ◽  
2020 ◽  
Vol 95 (12) ◽  
pp. 532-536
Author(s):  
Stéphane Mathis ◽  
Jean-Michel Vallat ◽  
Joachim Weis
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Natural Science ◽  
Life Sciences ◽  
The Other ◽  
History Of

Medicine and botany are 2 distinct disciplines of “natural science,” one focusing on humans, the other on plants. However, among the life sciences, both were quite close in earlier times. Moreover, the history of neuropathology, especially in the field of the peripheral nervous system, has been marked by many examples of “botanical images” used to describe certain histopathologic structures. We propose to better understand the reasons why neuropathologists used these botanical terms from a number of interesting anecdotes.

scholarly journals Lighting Strikes Twice: Recurrent Guillain–Barré Syndrome (GBS) after Influenza Vaccination

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Gregory Griffin ◽  
Brittany Cunningham ◽  
Jonathan M. Beary ◽  
Yonatan Spolter ◽  
Richard Gandee ◽  
...  
Keyword(s):  
Nervous System ◽  
Influenza Vaccine ◽  
Influenza Vaccination ◽  
Peripheral Nervous System ◽  
Guillain Barre Syndrome ◽  
Guillain Barré Syndrome ◽  
History Of ◽  
Guillain Barré

Guillain–Barré syndrome (GBS) is a rare acute demyelinating syndrome of the peripheral nervous system that is commonly preceded by infection. Vaccinations have also been associated with an increased incidence of GBS, though the risk is low. Caution with revaccination is recommended in patients with a history of GBS. Risks of revaccination compared with the risks of influenza complications should be considered. Patients who experience GBS after vaccination have not been shown to have an increased incidence of recurrent GBS after the influenza vaccine, though evidence is limited. We report a case of recurrent GBS in a patient following the influenza vaccine.

Z-line degradation and phagocytosis of sarcomeric fragments in myonecrosis

1983 ◽  
Vol 41 ◽  
pp. 790-791
Author(s):  
Melinda L. Estes ◽  
Samuel M. Chou
Keyword(s):  
Vastus Lateralis ◽  
Inflammatory Myopathy ◽  
Muscle Disease ◽  
White Female ◽  
Inflammatory Cell Infiltrate ◽  
Limb Weakness ◽  
Muscle Diseases ◽  
History Of ◽  
The Right ◽  
Mononuclear Inflammatory Cell

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.

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