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Clinical Manifestation and Diagnosis of MG
Dr. Li - Clinical Manifestation and Diagnosis of M ...
Dr. Li - Clinical Manifestation and Diagnosis of MG
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The document discusses three cases related to the diagnosis of myasthenia gravis (MG) and its differential diagnoses. <br /><br />Case #1 involves a 32-year-old female with weakness in her legs and difficulty with activities such as brushing hair and teeth. She experienced fatigue, and symptoms were worse in the morning. Initial suspicion was myasthenia gravis or myopathy, but various tests came back normal. An electromyogram (EMG) revealed myositis, and the patient was treated with IV methylprednisolone and IVIG. The final diagnosis was seronegative myasthenia gravis.<br /><br />Case #2 features a 69-year-old female who developed double vision and slurred speech. She had eaten potentially contaminated food and experienced gastrointestinal symptoms. The patient was diagnosed with botulism, which presented as flaccid quadriplegia. Treatment included plasmapheresis, and the patient slowly recovered over time.<br /><br />Case #3 involves a young patient with an enlarged thymus gland who presented with symptoms of ophthalmopathy and dysphagia. Further workup revealed Graves' disease with mild ophthalmopathy but no evidence of myasthenia gravis.<br /><br />The document also provides information on differentiating botulism from Lambert-Eaton myasthenic syndrome (LEMS) and myopathy from myasthenia gravis. It notes that while these conditions typically have distinct features, there can be overlap and coexistence of other conditions. The importance of thorough evaluation, including imaging and electrophysiological testing, is highlighted in making an accurate diagnosis.
Keywords
myasthenia gravis
differential diagnoses
case study
weakness
diagnosis
myopathy
electromyogram
seronegative myasthenia gravis
botulism
flaccid quadriplegia
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