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球部重症肌无力诊断中以顽固性恶心为主:一例病例研究及文献综述

Predominant Intractable Nausea in the Diagnosis of Bulbar Myasthenia Gravis: A Case Study and Review of Literature.

作者信息

Nagar Tripti, Ramakrishna Jahanavi M, Khanna Vatsal, Turk Issam

机构信息

Internal Medicine, Wayne State University School of Medicine, Rochester Hills, USA.

Internal Medicine, Wayne State University, Rochester Hills, USA.

出版信息

Cureus. 2022 Dec 15;14(12):e32553. doi: 10.7759/cureus.32553. eCollection 2022 Dec.

Abstract

Gastrointestinal (GI)-predominant myasthenia gravis (MG) is rare and presents a complex clinical scenario. We report the case of a 73-year-old female with dysphagia and intractable nausea found to have bulbar MG. Her symptoms persisted despite conventional MG management with plasma exchange therapy and anticholinergics. We review existing literature and discuss the clinical manifestations, diagnosis, and treatment of bulbar MG. This case highlights the need for novel MG treatment modalities in patients like ours with anomalous, GI-predominant MG who might not respond to conventional management.

摘要

以胃肠道(GI)为主的重症肌无力(MG)较为罕见,临床表现复杂。我们报告了一例73岁女性患者,该患者有吞咽困难和顽固性恶心,诊断为延髓性重症肌无力。尽管采用血浆置换疗法和抗胆碱能药物进行常规重症肌无力治疗,但其症状仍持续存在。我们回顾了现有文献,并讨论了延髓性重症肌无力的临床表现、诊断和治疗。该病例凸显了对于像我们这位患有异常的、以胃肠道为主的重症肌无力且可能对常规治疗无反应的患者,需要新的重症肌无力治疗模式。

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本文引用的文献

1
Clinical features of laryngeal myasthenia gravis: A case series.喉重症肌无力的临床特征:病例系列报道
Am J Otolaryngol. 2019 Mar-Apr;40(2):292-296. doi: 10.1016/j.amjoto.2018.11.002. Epub 2018 Nov 5.
2
The Spectrum of Autonomic Dysfunction in Myasthenic Crisis.重症肌无力危象中的自主神经功能障碍谱
Ann Indian Acad Neurol. 2018 Jan-Mar;21(1):42-48. doi: 10.4103/aian.AIAN_270_17.
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A rare cause of Dysphagia: a case report.吞咽困难的罕见病因:一例报告
Indian J Otolaryngol Head Neck Surg. 2011 Jul;63(Suppl 1):83-4. doi: 10.1007/s12070-011-0207-9. Epub 2011 Apr 11.
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Myasthenia gravis with autoimmune autonomic neuropathy.重症肌无力合并自身免疫性自主神经病变
Auton Neurosci. 2001 May 14;88(3):187-92. doi: 10.1016/S1566-0702(01)00239-9.
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Dysphagia in elderly men with myasthenia gravis.老年男性重症肌无力患者的吞咽困难
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