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Anti-musk positive myasthenia gravis and three semiological cardinal signs

André P.C. Matta, Ana C. Andorinho F. Ferreira, Arielle Kirmse, Anna Carolina Damm, João Gabriel D.I.B. Farinhas, Mariane D. Barbosa, Mayara C.M. Teles, Camila Fiorelli, Rossano Fiorelli, Osvaldo J.M. Nascimento, Marco Orsini
  • André P.C. Matta
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói, Brazil | andrepcmatta@hotmail.com
  • Ana C. Andorinho F. Ferreira
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói, Brazil
  • Arielle Kirmse
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói, Brazil
  • Anna Carolina Damm
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói, Brazil
  • João Gabriel D.I.B. Farinhas
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói, Brazil
  • Mariane D. Barbosa
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói, Brazil
  • Mayara C.M. Teles
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói, Brazil
  • Camila Fiorelli
    Medicine School, UNIRIO, RJ, Brazil
  • Rossano Fiorelli
    Medicine School, UNIRIO, RJ, Brazil
  • Osvaldo J.M. Nascimento
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói, Brazil
  • Marco Orsini
    Neurology Service, Federal Fluminense University, University Hospital Antônio Pedro, Niterói; Masters Program in Urgency and Medicine Emergency Care, USS, Vasssouras, Rio de Janeiro, Brazil

Abstract

Myasthenia gravis (MG) is a relatively uncommon disorder with an annual incidence of approximately 7 to 9 new cases per million. The prevalence is about 70 to 165 per million. The prevalence of the disease has been increasing over the past five decades. This is thought to be due to better recognition of the condition, aging of the population, and the longer life span of affected patients. MG causes weakness, predominantly in bulbar, facial, and extra-ocular muscles, often fluctuating over minutes to weeks, in the absence of wasting, sensory loss, or reflex changes. The picture of fluctuating, asymmetric external ophthalmoplegia with ptosis and weak eye closure is virtually diagnostic of myasthenia. We report an atypical MG case with three semiological cardinal signs.

Keywords

Neurology; Medicine; Neuromuscular diseases

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Submitted: 2015-12-10 17:26:43
Published: 2017-01-05 09:30:21
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Copyright (c) 2016 André P.C. Matta, Ana C. Andorinho F. Ferreira, Arielle Kirmse, Anna Carolina Damm, João Gabriel D.I.B. Farinhas, Mariane D. Barbosa, Mayara C.M. Teles, Camila Fiorelli, Rossano Fiorelli, Osvaldo J.M. Nascimento, Marco Orsini

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