gms | German Medical Science

87th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

04.05. - 07.05.2016, Düsseldorf

Head and neck manifestations of Myasthenia gravis – our experience

Meeting Abstract

  • corresponding author Petar Kolev - Ministry of Interior Medical Institute, Sofia, Bulgaria
  • Stefan Stoyanov - ENT clinic, Ministry of Interior Medical Institute, Sofia, Bulgaria
  • Kosta Kostov - Neurology Clinic, Ministry of Interior Medical Institute, Sofia, Bulgaria
  • Svetla Vasileva - ENT clinic, Ministry of Interior Medical Institute, Sofia, Bulgaria

Deutsche Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. 87. Jahresversammlung der Deutschen Gesellschaft für Hals-Nasen-Ohren-Heilkunde, Kopf- und Hals-Chirurgie. Düsseldorf, 04.-07.05.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. Doc16hnod024

doi: 10.3205/16hnod024, urn:nbn:de:0183-16hnod0248

Published: March 30, 2016

© 2016 Kolev et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

Text

The aim of our poster is to present several cases of Myasthenia gravis (MG) patients with head and neck manifestations including ocular ptosis, laryngeal paresis, dysphagia and velopharyngeal insufficiency.

Materials and methods: These MG patients were referred to our clinic in 2015 for evaluation on the account of their complaints. Among the used methods were full neurological and ENT examinations, CT scan of neck and mediastinum (one had untrearted thymoma), fibrolaryngoscopy, serological testing for AChR antibodies.

Discussion/conclusion: Myasthenia gravis (MG) is a relatively rare autoimmune disorder in which antibodies form against acetylcholine nicotinic postsynaptic receptors at the neuromuscular junction of skeletal muscles. The usual initial complaint is a specific muscle weakness that progresses to the more severe generalized form in most patients, producing severe muscular deterioration. As far as the head and neck region is concerned, most common is extraocular muscle weakness or ptosis ; weakness of the facial muscles is almost always present. Laryngeal involvement manifests with flaccid paresis and dysphonia. Patients can also have dysphagia, hypernasality, and velopharyngeal insufficiency.

MG treatment includes medical therapy – anticholinesterase agents, immunosuppresive agents- and surgical thymectomy if a tymoma is present. Our patients were treated with corticosteroids with significant improvement, one of them was referred for surgical treatment.

Although rare, MG should always be considered in the differential diagnosis of the neurological disorders of the head and neck region and it has to be distinguished from cranial nerve neuropathies and other infectious and non-infectious diseases that cause dysphonia, dysphagia, etc.

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