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32.  Ocular complications of Myasthenia Gravis.
1
UI  - 87103758
AU  - Lindahl G ; Lefvert AK ; Hedfors E
TI  - Periductal lymphocytic infiltrates in salivary glands in
      myasthenia gravis patients lacking Sj:ogren's syndrome.
AB  - In eight of eleven patients with clinical and serological
      evidence of myasthenia gravis (MG), immunohistological analysis
      of biopsies from labial salivary glands (LSG) showed focal
      periductal lymphocytic infiltrates, mainly composed of anti-Leu
      3a+ T helper lymphocytes, a finding usually regarded as
      indicative for Sj:ogren's syndrome (SS). None of the patients
      could however, according to functional criteria, be considered as
      having SS. This study thus indicates that lymphocytic infiltrates
      in LSG can be seen in MG, which has been thought of as an
      organspecific autoimmune disease with symptoms and signs confined
      to striated muscles.
MH  - Adolescence ; Adult ; Aged ; Autoimmune Diseases/*IMMUNOLOGY ;
      Cell Movement ; Child ; Female ; Helper Cells/*IMMUNOLOGY/
      PHYSIOLOGY ; Human ; Immunoenzyme Technics ; Lip/IMMUNOLOGY ;
      Lymphocytes/CLASSIFICATION ; Male ; Middle Age ; Myasthenia
      Gravis/*IMMUNOLOGY ; Salivary Glands/*IMMUNOLOGY ; Salivary
      Glands, Minor/*IMMUNOLOGY ; Sjogren's Syndrome/*IMMUNOLOGY ;
      Support, Non-U.S. Gov't
SO  - Clin Exp Immunol 1986 Oct;66(1):95-102
2
UI  - 87080477
AU  - Sollberger CE ; Meienberg O ; Ludin HP
TI  - The contribution of oculography to early diagnosis of myasthenia
      gravis. A study of saccadic eye movements using the infrared
      reflection method in 22 cases.
AB  - Saccadic eye movements were examined by infrared reflection
      oculography in 22 patients with suspected myasthenia gravis. In
      all of them the diagnosis was confirmed either by
      electromyography, by the presence of acetylcholine-receptor
      antibodies (15 cases), by a positive clinical Tensilon test (4
      cases), or by the course of the disease (3 cases). The aim of the
      study was to find out which of the saccade disorders described in
      myasthenic patients can be found in the early stage of the
      disease, and to discover their diagnostic value. Typically,
      saccade abnormalities were also seen in clinically uninvolved
      eyes. Intrasaccadic disorders mainly consisted of "decrescendo:
      of the velocity profiles (two-thirds of the cases) and
      "hypometria: (half of the cases). Postsaccadic "waver: was
      present in about two-thirds of the patients. The most frequent
      finding was "intersaccadic variation: (i.e., variation between
      repeated corresponding saccades) which occurred in 18 of the 22
      patients, and particularly affected the velocity profiles. A
      standardized fatigue test proved to be useful in accentuating
      mild, or provoking latent pathology in most of the patients. A
      standardized combined examination of saccades with Tensilon
      yielded pathological results less frequently than hitherto
      described in the literature. In 4 of the 9 patients with purely
      ocular myasthenia gravis oculography led to the diagnosis. The
      problems in attempting to delimit the observed saccade
      abnormalities from those found in other eye movement disorders
      are discussed.
MH  - Adult ; Aged ; Case Report ; *Eye Movements ; Female ; Human ;
      Male ; Middle Age ; Myasthenia Gravis/*DIAGNOSIS ;
      Ophthalmoplegia/DIAGNOSIS ; *Saccades
SO  - Eur Arch Psychiatry Neurol Sci 1986;236(2):102-8
3
UI  - 87044954
AU  - Sato S ; Baba H ; Inuzuka T ; Miyatake T
TI  - Anti-myelin-associated glycoprotein antibody in sera from
      patients with demyelinating diseases.
AB  - An enzyme-linked immunosorbent assay (ELISA) was developed for
      quantitating anti-myelin-associated glycoprotein (MAG) IgM
      antibody in human sera. Absorbance values of anti-MAG antibody
      were higher than 0.2 at 1:80 of serum dilution in sera from some
      patients with demyelinating diseases of the central or peripheral
      nervous systems including multiple sclerosis, subacute sclerosing
      panencephalitis, Guillain-Barr:e syndrome, chronic relapsing
      polyradiculoneuritis and carcinomatous polyneuropathy and also
      some patients with autoimmune diseases such as collagen diseases
      and myasthenia gravis. However, absorbance values of anti-MAG
      antibody in sera from control individuals and patients with some
      other neurological diseases were less than 0.2 and considered as
      negative. Because of the reported existence of a cross
      antigenicity between MAG and lymphocyte, and especially natural
      killer cells, the possibility of the functional importance of
      anti-MAG antibody on cellular immunity is discussed with
      particular reference to the demyelinating diseases.
MH  - Autoantibodies/*ANALYSIS ; Behcet's Syndrome/IMMUNOLOGY ;
      Cerebrovascular Disorders/IMMUNOLOGY ; Collagen Diseases/
      IMMUNOLOGY ; Comparative Study ; Demyelinating Diseases/
      *IMMUNOLOGY ; Encephalitis/IMMUNOLOGY ; Human ; Multiple
      Sclerosis/IMMUNOLOGY ; Myasthenia Gravis/IMMUNOLOGY ; Myelin
      Proteins/*IMMUNOLOGY ; Polyradiculoneuritis/IMMUNOLOGY ;
      Spinocerebellar Degenerations/IMMUNOLOGY ; Subacute Sclerosing
      Panencephalitis/IMMUNOLOGY ; Support, Non-U.S. Gov't
SO  - Acta Neurol Scand 1986 Aug;74(2):115-20
4
UI  - 86129650
AU  - Monden Y ; Uyama T ; Nakahara K ; Fujii Y ; Hashimoto J ; Ohno K
      ; Masaoka A ; Kawashima Y
TI  - Clinical characteristics and prognosis of myasthenia gravis with
      other autoimmune diseases.
AB  - Of 277 patients with myasthenia gravis (MG) who underwent
      thymectomy, including 78 with thymomatous MG, 33 patients had
      other autoimmune diseases. The clinical characteristics of MG
      with other autoimmune disease were investigated. Graves's disease
      and rheumatoid arthritis were the most common autoimmune diseases
      seen. The association rate of autoimmune disease in patients with
      thymomatous MG (3.8%) was significantly lower than that in
      patients with nonthymomatous MG (15.1%). The positive rate for a
      germinal center in the thymus was significantly higher in
      patients with other autoimmune disease than in those without such
      disease. Thymectomy was effective for MG in patients with an
      associated disease as well as in those without such a
      complication. The clinical course of the associated autoimmune
      disease did not seem to be adversely affected by thymectomy.
      Therefore, thymectomy should be performed in MG patients with
      other autoimmune disease.
MH  - Arthritis, Rheumatoid/COMPLICATIONS ; Autoimmune Diseases/
      *COMPLICATIONS ; Female ; Graves' Disease/COMPLICATIONS ; Human ;
      Male ; Myasthenia Gravis/*COMPLICATIONS/PATHOLOGY/SURGERY ;
      Prognosis ; Thymectomy ; Thymus Gland/PATHOLOGY
SO  - Ann Thorac Surg 1986 Feb;41(2):189-92
5
UI  - 86312282
AU  - Mapelli G ; De Palma P ; Franco F ; Fini M
TI  - Myasthenia gravis and recurrent retrobulbar optic neuritis: an
      unusual combination of diseases.
AB  - A case is presented that illustrates the unusual concurrence of
      both myasthenia gravis and recurrent retrobulbar optic neuritis.
      The association of optic neuritis with myasthenia gravis might
      support the idea that there is a disorder of immune function in
      optic neuritis.
MH  - Adult ; Autoimmune Diseases/COMPLICATIONS ; Case Report ; Female
      ; Human ; Myasthenia Gravis/*COMPLICATIONS ; Optic Neuritis/
      *COMPLICATIONS ; Recurrence
SO  - Ophthalmologica 1986;192(4):234-7
6
UI  - 86278886
AU  - Rosenberg ML
TI  - Spasm of the near reflex mimicking myasthenia gravis.
AB  - Spasm of the near reflex and myasthenia gravis both may present
      as isolated abduction deficits, either unilaterally or
      bilaterally. Although they each have been mistaken for other more
      serious causes of neurologic dysfunction, convergence spasm has
      not been reported previously as mimicking myasthenia gravis. Two
      cases of convergence spasm were diagnosed initially as myasthenia
      gravis with positive Tensilon tests. The cases emphasize the need
      to consider convergence spasm in the diagnosis of any patient
      with isolated abduction deficits, as well as to suggest that
      double-blinded Tensilon tests may be unnecessary and possibly
      misleading.
MH  - Accommodation, Ocular ; Adult ; Case Report ; Convergence, Ocular
      ; Diagnostic Errors ; Edrophonium/DIAGNOSTIC USE ; Eye Diseases/
      *DIAGNOSIS ; Female ; Human ; Male ; Middle Age ; Myasthenia
      Gravis/*DIAGNOSIS ; Ophthalmoplegia/*DIAGNOSIS ; Reflex, Abnormal/
      *DIAGNOSIS ; Spasm/*DIAGNOSIS
SO  - J Clin Neuro Ophthalmol 1986 Jun;6(2):106-8
7
UI  - 86185358
AU  - Dooley JM ; Goulden KJ ; Gatien JG ; Gibson EJ ; Brown BS
TI  - Topical therapy for oropharyngeal symptoms of myasthenia gravis.
AB  - Inhibitors of acetylcholinesterase are commonly used in the
      treatment of myasthenia gravis. We studied a patient with mainly
      bulbar myasthenia gravis who did not tolerate oral pyridostigmine
      despite a clear clinical response. Treatment with nebulized
      pyridostigmine reduced her symptoms without systemic side
      effects. This route of therapy may benefit other patients.
MH  - Aerosols ; Blepharoptosis/DRUG THERAPY ; Case Report ; Child ;
      Deglutition Disorders/DRUG THERAPY ; Female ; Human ; Myasthenia
      Gravis/COMPLICATIONS/*DRUG THERAPY ; Ophthalmoplegia/DRUG THERAPY
      ; Pyridostigmine Bromide/*ADMINISTRATION & DOSAGE ; Speech
      Disorders/DRUG THERAPY
SO  - Ann Neurol 1986 Feb;19(2):192-4
8
UI  - 86169890
AU  - Noroian EL
TI  - Myasthenia gravis: a nursing perspective.
AB  - Myasthenia gravis, a chronic neuromuscular disease, results in
      weakness of striated voluntary muscles. The muscles involved and
      the degree of weakness vary from patient to patient. Nursing care
      of the patient with muscle weakness from myasthenia gravis
      presents a challenge for the neuroscience nurse. Drug therapy and
      thymectomy treatments are discussed, along with their
      complications. Nursing interventions for other problems for the
      myasthenic patient, including impaired breathing patterns,
      inability to clear the airway, impaired communication, altered
      nutrition, self-care deficits, and impaired vision are described.
MH  - Activities of Daily Living ; Cholinesterase Inhibitors/
      THERAPEUTIC USE ; Deglutition ; Facial Expression ; Human ;
      Intermittent Positive Pressure Ventilation ; Mastication ;
      Myasthenia Gravis/COMPLICATIONS/*NURSING/THERAPY ; Panic ;
      Respiration Disorders/ETIOLOGY/NURSING ; Speech Disorders/
      ETIOLOGY/NURSING ; Vision Disorders/ETIOLOGY/NURSING
SO  - J Neurosci Nurs 1986 Apr;18(2):74-80
9
UI  - 86127578
AU  - Ellenhorn N ; Lucchese N ; Greenwald M
TI  - Juvenile myasthenia gravis and amblyopia.
AB  - In two girls, 26 and 36 months old, strabismus and blepharoptosis
      secondary to myasthenia gravis led to amblyopia. The initial
      symptoms in both patients were blepharoptosis and variable
      exotropia. Although the amblyopia was successfully treated in one
      patient, it persisted in the second despite therapy.
MH  - Amblyopia/DIAGNOSIS/*ETIOLOGY ; Case Report ; Child, Preschool ;
      Female ; Human ; Myasthenia Gravis/*COMPLICATIONS/DIAGNOSIS
SO  - Am J Ophthalmol 1986 Feb 15;101(2):214-7
10
UI  - 86094074
AU  - Siegel IM
TI  - The many faces of neuromuscular disease.
AB  - It has been said that "the face is the mirror of the mind.: It
      also appears that the face may reflect a state of generalized
      disease. Familiarity with the common facial features of
      neuromuscular disease can assist in correct diagnosis and
      treatment of these conditions, which may present many faces. Four
      photographs exhibiting some of the neuromuscular diseases
      discussed in this article have been provided (see box) to test
      your skill in diagnosis. The correct answers are below the
      pictures.
MH  - Dermatomyositis/DIAGNOSIS ; Endocrine Diseases/DIAGNOSIS ; *Face
      ; Facial Paralysis/DIAGNOSIS ; Female ; Human ; Male ; Muscular
      Atrophy/DIAGNOSIS ; Muscular Dystrophy/DIAGNOSIS/FAMILIAL &
      GENETIC ; Myasthenia Gravis/DIAGNOSIS ; Myositis/DIAGNOSIS ;
      Myotonia Atrophica/DIAGNOSIS ; Neuromuscular Diseases/*DIAGNOSIS
      ; Ophthalmoplegia/DIAGNOSIS
SO  - Postgrad Med 1986 Jan;79(1):121-2, 125, 128-34 passim