Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0030552 (paresis)
 5,831 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Laryngeal myasthenia gravis is a relatively rare variant of myasthenia gravis. A vast portion of patients with initial laryngeal myasthenia gravis develop involvement of ocular and/or extra-ocular muscles during the years after symptom onset although a minority of laryngeal myasthenia gravis patients continues to have isolated laryngeal muscle involvement for several years. We present a 58-year-old woman with recurrent episodic isolated dysphonia (associated with diffuse bilateral vocal cord paresis on laryngoscopy) since the age of 32. Dysphonia became permanent since 6 months. A diagnosis of laryngeal myasthenia gravis was made based on abnormal single-fiber electromyography and spectacular response to pyridostigmine treatment. Repetitive nerve stimulation was normal and anti-acetylcholine receptor and anti-muscle specific tyrosine kinase antibodies were absent. This case shows that laryngeal myasthenia gravis can be isolated during 26 years of follow-up. We propose that even when myasthenia gravis seems unlikely as underlying mechanism of isolated dysphonia (because of lack of antibodies, normal repetitive nerve stimulation, and absence of extra-laryngeal involvement after years of follow-up), single-fiber electromyography should be performed and myasthenia gravis treatment should be tried.
...
PMID:Isolated laryngeal myasthenia gravis for 26 years. 2545 67

Consequences of an upper motor neuron syndrome (UMNS) include voluntary weakness or paresis, superimposed involuntary phenomena such as spastic co-contraction and associated reactions, and superimposed rheologic changes in affected muscles. This article describes the use of dynamic poly-electromyography to assess UMNS muscle overactivity and inform muscle selection for chemodenervation. Cases are presented that involve spastic co-contraction, spastic dystonia, associated reactions, hyperextended wrist and finger flexor tenodesis, differentiating neural versus non-neural (rheologic) hypertonia, upper motor neuron weakness, muscle selection for chemodenervation, and electrical stimulation for muscle specific targeting.
 ...
PMID:Upper Extremity Problem-Solving: Challenging Cases. 3062 17