Oculobulbar form of Myasthenia Gravis: Unusual Diagnosis in ORL Outpatient

Czech version

Authors: J. Heřman ¹; E. Maňásková ¹; Richard Salzman ¹; T. Dorňák ²
Authors‘ workplace: Otorinolaryngologická klinika FN Olomouc ; přednosta prof. MUDr. I. Stárek, CSc. Neurologická klinika FN Olomouc ¹; přednosta prof. MUDr. P. Kaňovský, CSc. ²
Published in: Otorinolaryngol Foniatr, 62, 2013, No. 4, pp. 214-217.
Category: Case History

Overview

Myasthenia gravis is the most common disorder of the neuromuscular junction, which manifests with painless, fluctuating muscular weakness and fatigability of affected skeletal muscle groups. Seropositive and seronegative forms are distinguished according to presence of anti-ACHR antibodies. Ocular (double vision, drooping eyelid), oculobulbar (involvement of the eyes and ENT area – hoarseness, dysphagia, dysarthria and rarely shortness of breath) and generalized form, where limbs are also affected, are recognized according to clinical findings.

Involvement of the oropharynx or larynx may bring the patient to ENT specialist. The condition is possibly often misdiagnosed because of its low prevalence. Patients with suspected myasthenia gravis should be referred to a neurologist, who should examine, diagnose and treat the condition, cooperating with other specialists including an ENT doctor.

Here we describe two myasthenia gravis patients with ENT symptoms who presented with stridor and changing mobility of vocal cords.

Keywords:
myasthenia gravis - diagnostics, treatment, dysphagia, dysarthria, dysphonia, inspiratory stridor

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