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Unusual neurophysiological and immunological findings in myasthenia gravis: a case report
Author(s) -
Scaioli Vidmer,
Andreetta Francesca,
Mantegazza Renato
Publication year - 2004
Publication title -
journal of the peripheral nervous system
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1
H-Index - 67
eISSN - 1529-8027
pISSN - 1085-9489
DOI - 10.1111/j.1085-9489.2004.09207.x
Subject(s) - myasthenia gravis , weakness , medicine , polyradiculoneuropathy , repetitive nerve stimulation , neuromuscular junction , peripheral neuropathy , chronic inflammatory demyelinating polyneuropathy , electrophysiology , compound muscle action potential , lambert eaton myasthenic syndrome , motor nerve , antibody , immunology , guillain barre syndrome , neuroscience , diabetes mellitus , endocrinology , surgery , anatomy , psychology
We describe the case of a male patient with ocular myasthenia gravis who developed a diabetic neuropathy similar to chronic inflammatory demyelinating polyradiculoneuropathy associated with transient generalized ‘myokymic’ discharges and distal weakness. He had antibodies against acetylcholine receptor and GQ1b ganglioside, but not anti‐voltage‐gated K + channel antibodies. Serial electrophysiological and immunological findings showed that diabetes was involved in the immune‐mediated mechanism of peripheral neuropathy. We hypothesize that the concomitant appearance of distal motor weakness and decreased compound muscle action potentials upon repetitive nerve stimulation, together with increased distal motor latency and generalized peripheral nerve hyperexcitability, were all related to transient serum positivity to anti‐GQ1b antibodies.