SEARCH · PubMed Health

Results for “MYASTHENIA”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 415 records · Page 23Linked to original sources

PubMed1969

Myasthenia gravis: comparative evaluation of medical and surgical treatment.

Sixty-eight patients with myasthenia gravis were evaluated and compared to determine the results of medical and surgical treatment; eight patients with thymoma were evaluated separately. In the group of 30 non-thymoma patients treated medically 50% of patients derived moderate to good improvement over a mean follow-up period of 11 years. Ten per cent of patients in this group died from myasthenia.In the group of 30 non-thymoma patients treated by thymectomy, 83% achieved good to excellent improvement. There was no surgical or myasthenic mortality over a mean follow-up period of nine years.The results of treatment in the eight thymoma patients were decidedly inferior and there was no significant difference between the medically and surgically treated patients. Fifty per cent showed only moderate improvement during a mean follow-up of five years and 50%, after initial improvement, deteriorated later and died from myasthenia between three and four years after thymectomy.Two additional patients had thymoma without myasthenia. Neither of them had developed myasthenia, two years following thymectomy in one case and after 25 years in the other, despite recurrence of the tumour with extensive invasiveness in the very long-standing case.

Adolescent↗

PubMed1979

[Myasthenia gravis. Indications, aims and methods of intensive therapy].

Some recent views on pathophisyology of "myasthenia gravis" are presented. The Authors explain the typical damage of myasthenia gravis, i.e. the progressively reduced muscolar function on the basis of an autoimmune derangement affecting the motor-end plates. The most commonly used types of treatment, both medical (i.e. antiChE, A.C.T.H., steroids and immunodepressant drugs) and surgical (thymectomy) are reviewed. The very important role of Intensive Care for the treatment either of myasthenia gravis "per se" or of possible consequences of some drugs (A.C.T.H. steroids) is also stressed. Finally the Authors present their results about their experience on 36 patients affected by myasthenia gravis and admitted to I.C.U. once (29 patients) or twice or more (7 patients). The Authors describe some practical problems presented by patients during their stay in I.C.U.

Adolescent↗

PubMed1980

Gm allotypes in myasthenia gravis.

Gm typing and acetylcholine receptor antibody assay were performed on serum samples from 74 patients with myasthenia gravis (31 male, 43 female) and from 236 unrelated normal blood-donors. The haplotype Gm1,2,21 was significantly more common in patients with myasthenia gravis (relative risk = 3.24), especially those with thymoma (relative risk = 6.99). The frequency of haplotype Gm1,2,21 was further increased in patients with severe generalised myasthenia gravis (relative risk = 10.52). The frequency of Gm1,2,21 was also increased in patients with high acetylcholine receptor antibody titres (greater than 5 pmol/ml). The results indicate the presence of a pathogenic gene close to the IgG heavy-chain gene complex in the 6th chromosome in the patients with myasthenia gravis, especially those with thymoma.

Adolescent↗

PubMedDate not supplied

[Association between mycosis fungoides and myasthenia gravis (author's transl)].

Myasthenia gravis characterized by physical examination, electrophysiologic abnormalities, ephedronium test, without thymoma, associated in a 47 year-old-man, with mycosis fungoides. Myasthenia gravis began two years after the onset of mycosis fungoides, and the patient died of infection four years after the development of the cutaneous lymphoma. At autopsy, there was no visceral involvement. Myasthenia gravis and lymphoma rarely coexist; the occurrence of myasthenia gravis shortly after the onset of mycosis fungoides suggests that the two disorders may be linked by immunological abnormalities.

Autoantibodies↗

PubMed1982

[Evaluation of treatment of myasthenia with thymectomy (author's transl)].

The paper describes the effectiveness of treatment of myasthenia with thymectomy in 136 patients operated on, observed in hospital and 107 examined by questionnaire on late results after 10 years. Exclusive of myasthenia with thymoma, cures were obtained in 26.4%, marked improvement in 19.6%, moderate improvement in 21.4%, improved motor strength in 27.1%, and deterioration was observed in 3.8%. The assessment was based mainly on the amount of cholinergic drugs taken. Early mortality rate was 2,4%, and late mortality 1,9%. Relation of postoperative complications/respiratory and crisis of both kinds to mortality and intraoperative pleural injury also surgical approach and anatomic variants of the thymus were discussed. An influence of the number of proliferating centers on prognosis in myasthenia after thymectomy was nor demonstrated. Thymectomy in a generally accepted and most effective method of treatment in myasthenia.

Adolescent↗

PubMed1984

[Myasthenia gravis. Information for the anesthetist and critical care physician].

Myasthenia gravis is an autoimmune-disorder and clinically characterised by weakness of voluntary muscles including respiratory and pharyngeal muscles. As myasthenia gravis is a rare disease surgeons and anesthesiologists are only seldomly confronted with patients suffering from this disease. However, the application of narcotics or of other drugs may lead to the manifestation of a subclinical form of myasthenia gravis or provoke a critical exacerbation of the patient's condition with severe respiratory and bulbar dysfunction. This paper describes guidelines for the use of narcotic drugs or other pharmacotherapy in myasthenia gravis patients. On the other hand this paper gives information about the intensive care and management of patients suffering from myasthenic of cholinergic crisis, which is known to be a lifethreatening emergency. Finally, the paper describes shortly the long-term treatment with immunosuppressive or immunoregulatory measures.

Adult↗

PubMed1984

[Oculomotor forms of myasthenia].

The diagnostic difficulty in purely oculo-motor forms of myasthenia can be due to the lack of fluctuation in symptoms, the occurrence of complete spontaneous remissions, lasting several months or years, the absence of a decremental response in muscle potentials as evidenced by classical repetitive stimulation of the motor nerve, and negative responses to pharmacological testing. Thus, several investigative procedures have been developed to aid in the diagnosis of questionable cases. These include electromyography of proximal muscles and single fiber recordings, the dosage of acetylcholine receptors antibodies (specificity of nearly 100 %), and histological examination of neuro-muscular junction (invariably finding specific lesions of motor end plates). In spite of the diffuse pathological process and the possible overlapping with other types of myasthenia, many oculo-motor forms remain strictly localized throughout their course. Furthermore the prognosis of oculo-motor myasthenia is far better than other forms. Several hypotheses exist to explain the peculiarities of ocular myasthenia. Among these explanations are the theories that there are structural factors specific to oculo-motor muscles and that there exist a heterogeneity of acetylcholine receptor antibodies. On the therapeutic grounds, the frequent failure of anticholinesterase agents has been established. Corticosteroids are often very efficacious, but require high maintenance doses. The adverse side effects of such therapy have led some authors to suggest thymectomy as an alternative therapeutic modality.

Adult↗

PubMed1984

D-penicillamine-induced myasthenia gravis in primary biliary cirrhosis.

A 62-yr-old woman with recently diagnosed primary biliary cirrhosis was started on D-penicillamine, 250 mg twice daily. Within 9 mo, she developed myasthenia gravis, associated with elevated antiacetylcholine receptor antibody titers and abnormalities of single-fiber electromyography. The D-penicillamine was withdrawn and pyridostigmine bromide was prescribed. The latter drug was slowly reduced, and at the end of 6 mo stopped, after a full recovery by the patient. The clinical response was paralleled by a fall in the antiacetylcholine receptor antibody titer into the normal range and reversal of the previously abnormal single-fiber electromyographic findings. The human leukocyte antigen type of the patient was not that typically associated with classic myasthenia gravis. It is suggested that D-penicillamine-induced myasthenia gravis is due to an independent effect of the drug on the immune system rather than to the unmasking of subclinical myasthenia gravis.

Autoantibodies↗

PubMed1980

Specificities of antibody to acetylcholine receptor in rabbits with experimental myasthenia gravis.

The injection of acetylcholine receptor (AChR) purified from Narke electroplax japonica induced 'experimental autoimmune myasthenia gravis' (EAMG) in rabbits. Serial measurements of anti-AChR antibody titre using Narke AChR and rabbit AChR as antigen revealed that the intensity of myasthenia had a rather closer correlation with titre to Narke AChR than that to rabbit AChR. Antibody reacting to rabbit AChR was almost completely adsorbed out with torpedo receptor conjugated to agarose. Serum concentrations of antibody protein measured by affinity chromatography ranged from 54 to 896 microgram/ml serum and were well correlated with the intensity of myasthenia. The results suggested that in rabbits immunized with heterologous AChR the cross-reaction of anti-heterologous AChR antibody with rabbit AChR caused myasthenia rather than an immune response specific to rabbit AChR dose.

Acetylcholine↗

PubMed1981

Antibodies to polyadenylic acid in patients with myasthenia gravis.

Sera from 100 patients with myasthenia gravis and 45 patients with non-myasthenia gravis neuromuscular diseases were studied for antibodies to poly rA, poly rA-rU, native and denatured DNA. All patients with myasthenia gravis had significant anti-acetylcholine receptor antibodies with a mean titre of 1.2 X 10(-7)M. Forty-eight per cent of the myasthenia gravis patients had anti-poly rA antibody levels which were greater than 3 standard deviations from the mean of 65 control patients by Millipore filter radioimmunoassay. The antibody was specific for poly rA and present in a much higher frequency than antibodies to the other nucleic acids tested. Sucrose-gradient ultracentrifugation demonstrated that the antibody was limited to the IgM class alone. Mechanisms relating these findings to a more generalized immunological dysfunction are discussed.

Antibodies↗

PubMed1981

The thymus and myasthenia gravis.

The relationship between the thymus and the pathogenesis of myasthenia gravis is reviewed. Ten cases of myasthenia gravis who underwent thymectomy at the American University Hospital of Beirut are presented. The various pathologic features of the thymus encountered in myasthenia gravis are presented. The indications for thymectomy and the results of surgical intervention on the course of the disease are reviewed. The conclusion is made that thymectomy should be done on all patients with generalized myasthenia gravis irrespective of age, sex, duration of disease or pathological features of the thymus.

Adolescent↗

PubMed1995

[Exacerbation of myasthenia gravis by pefloxacin].

Pefloxacine 800 mg single dose was given as routine treatment after a cystomanometric examination to a 45-year-old woman with a 30-month history of generalized myasthenia gravis. One hour after, the patient developed exacerbation of myasthenia gravis with bilateral ptosis and an increased generalized weakness. She experienced a rapid improvement during the next 8 hours and physical examination returned to normal within one day. No additional factors which might have contributed to the exacerbation of myasthenia gravis were found. The report of exacerbation of myasthenia gravis with other antibiotic belonging to the group of fluoroquinolones (ciprofloxacin, norfloxacin and ofloxacin) prompt us to recommend caution with the use of all fluoroquinolones in myasthenic patients.

Anti-Infective Agents↗

PubMed1995

Third degree atrioventricular block and acquired myasthenia gravis in four dogs.

Third degree atrioventricular block was diagnosed in 4 dogs with acquired myasthenia gravis (serum acetylcholine receptor antibody titer > 0.6 nmol/L). All 4 dogs had megaesophagus. Two dogs also had mediastinal thymomas, which were resected. One dog with thymoma received a permanent pacemaker at the same time that it underwent thymectomy; the other did not develop third degree atrioventricular block until 3 months after thymectomy. Both dogs with thymoma died of severe aspiration pneumonitis within 3 months after surgery. The third dog received a permanent pacemaker and was treated with pyridostigmine bromide, but also died of aspiration pneumonitis 1 month after the pacemaker was implanted. The fourth dog was treated with prednisolone and pyridostigmine bromide and improved, but did not become clinically normal. Because third degree atrioventricular block as well as myasthenia gravis can cause signs of weakness, acquired myasthenia gravis should be considered in dogs with idiopathic cardiac conduction disturbances. Likewise, an ECG should be evaluated in dogs with acquired myasthenia gravis.

Animals↗

PubMed1995

[Transient neonatal myasthenia gravis].

Authors reported about their experiences with newborn infants, who had transient myasthenia gravis; one disease developed in the fetal, others 10 in the early neonatal age. Direct correlation was found between the development of maternal polyhydramnios and the severity symptoms in newborns: risk of neonatal myasthenia gravis increased at these infants. Specific treatment included blood exchange transfusions and pyridostigmin (Mestinon) medication for 2-10 weeks. Five transient myasthenia gravis responded readily to blood exchange transfusions. Authors pointed out that in the early neonatal period the aetiology of an obscure respiratory inadequacy and hypoventilation might be regarded as transient myasthenia gravis.

Adult↗

PubMed1994

Myogenesis in thymic transplants in the severe combined immunodeficient mouse model of myasthenia gravis. Differentiation of thymic myoid cells into striated muscle cells.

Thymic myoid cells (TMCs) bearing acetylcholine receptors (AchR) on their surface have a central role in the concept of intrathymic autosensitization in the pathogenesis of myasthenia gravis. In a SCID mouse model of myasthenia gravis, solid pieces of thymuses with lymphofollicular hyperplasia were transplanted into SCID mice. The chimeric mice displayed long-term secretion of anti-AchR antibodies. Here, we traced the fate of TMCs contained in transplanted myasthenia gravis thymuses. Unexpectedly, the number of thymic TMCs in transplanted tissue was slightly higher than in untransplanted thymus. More strikingly, the transplanted TMCs were more highly differentiated than their nontransplanted counterparts. This was demonstrated by a more than 10-fold increase of AchR-main immunogenic region epitopes recognized by monoclonal antibody 198. Some TMCs had even differentiated into striated muscle cells. The abundance of AchRs in human thymic transplants in the SCID mouse model of myasthenia gravis may help to study the mechanisms of autosensitization against the AchR in vivo.

Animals↗

PubMed1993

[Diagnosis, surgical treatment and prognosis in patients with generalized myasthenia].

The work deals with the clinical analysis of the richest experience in the surgical treatment of patients with generalized myasthenia in the country. The efficacy of various methods for the diagnosis of affection of the thymus is studied comparatively. It is shown that for more effective diagnosis of neoplastic lesions of the thymus wider use of computerized and magneto-resonance tomography is expedient and that they must replace the insufficiently informative and invasive examination methods used today (pneumonodiastinography, phlebography, scintigraphy, etc.) which still form the basis for the system of diagnostic research in patients with myasthenia. The authors determined the indications and contraindications for, the optimum terms for undertaking the surgical intervention and its volume in neoplastic and nonneoplastic diseases of the thymus in adults and children. Comparative evaluation of various means of preoperative management was conducted. It is shown that to improve the patient's condition and stabilize the myasthenic status on the possibly minimal doses of anticholesteremic agents glucocorticoid hormones should be included in the complex of preoperative management. The indications for hormonotherapy were determined. The efficacy of plasmapheresis, radiotherapy, and glomectomy with denervation of the sinocarotid zone was evaluated and their place in the complex treatment of patients was determined. From study of the late-term results of treatment of a large group of patients (children, adults with a thymus) the main causes of unsuccessful surgical treatment of generalized myasthenia were identified and the concrete means of improving the results of treatment were planned. Two types of changes in the clinico-immuno-morphological values were revealed in patients with generalized myasthenia, differing evidently in pathogenesis. New clinico-immuno-morphological correlations and prognostic factors were discovered, and a method for prognosticating the effect of thymectomy was suggested. It is shown that splenectomy has a favorable effect in the most severe category of patients in unsuccessful operative and nonoperative treatment. The tactics of management of patients accepted in the clinic led to a uncomplicated course of the postoperative period in the majority of patients in the last years.

Adult↗

PubMedDate not supplied

[Myasthenia preceded by dysphonia. Clinical and electrophysical study].

The solely dysphonia symptom as atypical and relatively rare onset of myasthenia gravis is difficult to diagnose. We present 11 cases of myasthenia, where dysphonia was one and only one symptom of illness during several months to several years. The evidences of dysphonia were the fatigability and nasality of speech, as well as chronic hoarseness. The diagnosis of myasthenia was very difficult in this period and was often preceded by lengthy laryngological and neurological examination. In our paper we present the criteria proper for myasthenia diagnosis in which repetitive electrostimulation test and high-sensitive SFEMG method are used.

Adult↗

PubMed1997

Myasthenia gravis associated with thymolipoma: a case report.

A 31-year-old patient with a 2-year history of myasthenia gravis underwent resection of a mass in the anterior mediastinum. On histological examination, the tumour proved to be a thymolipoma. The association of thymolipoma with myasthenia gravis is rare. To our knowledge this is the 12th case reported. It is however the first in which histological examination revealed the presence of germinal centres. The tumour measured 28 x 14 x 2 cm and weighted 340 gr. This is by far the largest thymolipoma associated with myasthenia gravis reported. As in all previously published cases, the myasthenia associated symptoms improved significantly after surgery. In this case improvement occurred within weeks. In general, benefit after thymectomy is delayed until months to years.

Adult↗