Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In myasthenia gravis and amyotrophic lateral sclerosis the ENT specialist or the phoniatrician may be consulted first, because in about 30 percent of all cases the initial symptoms are dysarthria, dysphagia or dyspnea. Three typical cases of each condition are presented. The quality of life of the patients can be improved considerably by early diagnosis and treatment. Special diagnostic and therapeutic procedures are described.
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PMID:[Dysarthria, dysphagia or dyspnea as a reason for the initial consultation in pseudoparalytic myasthenia gravis and amyotrophic lateral sclerosis]. 231 Apr 61

We report on three cases of patients whose primary symptoms of myasthenia gravis were related to the upper aerodigestive tract. Symptoms had been present unrecognized in all patients for up to three years, and one patient subsequently developed a myasthenic crisis. We highlight the clinical features of myasthenia gravis to allow its prompt recognition in patients presenting to the ENT surgeon or physician.
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PMID:Bulbar presentations of myasthenia gravis in the elderly patient. 1123 14

Hearing disorders are a well-described symptom in patients with multiple sclerosis (MS). Unilateral or bilateral hyperacusis or deafness in patients with normal sound audiometry is often attributed to demyelinating lesions in the central auditory pathway. Less known in MS is a central phonophobia, whereby acoustic stimuli provoke unpleasant and painful paresthesia and lead to the corresponding avoidance behaviour. In our comparison collective, patient 1 described acute shooting pain attacks in his right cheek each time set off by the ringing of the telephone. Patient 2 complained of intensified, unbearable noise sensations when hearing nonlanguage acoustic stimuli. Patient 3 noticed hearing unpleasant echoes and disorders of the directional hearing. All patients had a clinical brainstem syndrome. ENT inspection, sound audiometry and stapedius reflex were normal. All three patients had pathologically changed auditory evoked potentials (AEPs) with indications of a brainstem lesion, and in magnetic resonance imaging (MRI) demyelinating lesions in the ipsilateral pons and in the central auditory pathway. The origin we presume in case 1 is an abnormal impulse conduction from the leminiscus lateralis to the central trigeminus pathway and, in the other cases, a disturbance in the central sensory modulation. All patients developed in the further course a clinically definite MS. Having excluded peripheral causes for a hyperacusis, such as, e.g., an idiopathic facial nerve palsy or myasthenia gravis, one should always consider the possibility of MS in a case of central phonophobia. Therapeutic possibilities include the giving of serotonin reuptake inhibitors or acoustic lenses for clearly definable disturbing frequencies.
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PMID:Central hyperacusis with phonophobia in multiple sclerosis. 1247 92

A 67-year-old patient suffering from an ocular myasthenia gravis was scheduled for an elective ENT surgery. General anaesthesia was induced intravenously. Neuromuscular responses after train-of-four stimulation were normal at both the adductor pollicis (T(4)/T(1) = 1) and the corrugator supercilii (4 visual responses). Then cisatracurium (0,15 mg kg(-1)) was administered to allow tracheal intubation. The laryngoscopy attempted 45 s after cisatracurium injection (no response at the supercilii, T(1)/T(0) = 1 at the adductor pollicis) was unsuccessful because of closing and moving vocal cords. The second attempt was successful 4 min after cisatracurium injection (no response at the corrugator supercilii, T(1)/T(0) = 0.05 at the adductor pollicis). Residual neuromuscular blockade was antagonized at the end of surgery (1 h long) allowing an uneventful extubation. We concluded that monitoring neuromuscular blockade at the corrugator supercilii to assess the intubating conditions is not recommended in a case of ocular myasthenia gravis.
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PMID:[Neuromuscular blockade monitoring at the corrugator supercilii and ocular myasthenia gravis]. 1274 94

Acute respiratory failure is an uncommon initial presentation of myasthenia gravis (MG). In our case a 22-year-old woman of unrecognized MG presented to the emergency department with isolated respiratory failure as the first presenting symptom. Initially she presented with dysphonia and was managed by speech therapist and ENT surgeons for 3 months. Subsequently, she presented with signs and symptoms of sepsis and went into acute respiratory failure. This case highlights the need to consider MG in the differential diagnosis of an otherwise unexplained respiratory failure in the critical care setting.
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PMID:An undiagnosed myasthenia gravis presenting as isolated recurrent acute respiratory failure. 2234 3

Dysphagia is a common clinical symptom for an ENT surgeon in his clinic, evaluation of which may not be a great challenge. The objective of this article is to report a rare cause of dysphagia which may be difficult to diagnose unless specifically thought of. This is a report of a case of dysphagia secondary to myasthenia gravis seen in a young lady along with tongue fasciculation in an early onset case unlike the ones reported in the literature where the patients are elderly and more often males in the late phase of the disease. At times, dysphagia may be seen secondary to some rare causes and may mislead the doctor. A carefully taken history and methodical clinical examination will avoid unnecessary invasive procedures and delay in the diagnosis.
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PMID:A rare cause of Dysphagia: a case report. 2275 48

Myasthenia gravis is an autoimmune disease, manifested by progressive muscular weakness and fatigue. There are frequent ocular and bulbar symptoms, among them, dysphonia. This article reports a case of dysphonia that contributed to the diagnosis of myasthenia gravis through a speech evaluation. The patient sought speech therapy with the ENT diagnosis of presbyphonia. The perceptual voice assessment and acoustic analysis pointed out respiration, glottal voice source and resonance affections. Considering that some of the data obtained from anamnesis and vocal assessments were not directly related to presbyphonia, the speech therapist discussed the case with the physician and they both concluded it was necessary to refer the patient to a neurological evaluation. The neurologist then raised the diagnostic hypotheses of myasthenia gravis and requested further examinations. The patient underwent speech therapy and drug treatment. A vocal reassessment, which occurred two months after the initial treatment, showed improvement in voice quality, with great impact on quality of life. This article shows the importance of detailed clinical speech evaluation and participation of a speech therapist in an interdisciplinary team.
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PMID:Dysphonia as the primary complaint in a case of myasthenia gravis: diagnosis and speech therapy. 2440 43

We present the case of a 79 year-old patient with megaesophagus and aphagia, who required percutaneous endoscopic gastrostomy (PEG) feeding. Megaesophagus was considered the sole cause of aphagia by the referring secondary hospital. Solid state sensor videofluoromanometry (VFM) showed a substantial decrease in manometric values within the hypopharynx along with good relaxation of the upper-esophageal sphincter (UES). This led to electromyography (EMG), which showed features compatible with the diagnosis of Myasthenia Gravis (MG). The diagnosis of MG was confirmed by an intravenous injection of edrophonium chloride, performed under VFM monitoring. The co-existence of MG and megaesophagus rarely occurs in humans; although, most small animals, such as dogs, cats, and rodents, present with megaesophagus as an initial symptom of MG.
B-ENT 2015
PMID:Megaesophagus associated with Myasthenia Gravis: a rare condition in humans. 2651 50