PMID- 33762493
OWN - NLM
STAT- MEDLINE
DCOM- 20210922
LR  - 20210922
IS  - 1882-0654 (Electronic)
IS  - 0009-918X (Linking)
VI  - 61
IP  - 4
DP  - 2021 Apr 21
TI  - [A case of elderly-onset myasthenia gravis mimicking stroke with dysarthria and 
      left upper extremity paresis].
PG  - 234-238
LID - 10.5692/clinicalneurol.cn-001523 [doi]
AB  - An 80-year-old woman presented with sudden-onset dysarthria and left-side 
      dominant quadriparesis and transferred to our hospital. A neurologic examination 
      revealed slurred speech, prominent left upper extremity weakness and mild 
      weakness of the other extremities. Brain MRI revealed a history of right-side 
      cerebral artery bypass surgery, but no new lesions indicative of stroke. Left 
      upper extremity weakness had improved soon after admission, so a transient 
      ischemic attack was suspected. After admission, the dysarthria fluctuated. The 
      patient's respiratory condition deteriorated several days later and she required 
      ventilation support. Assessment of the cause of the respiratory failure revealed 
      positive muscle-specific kinase (MuSK) antibodies, which suggested myasthenia 
      gravis (MG). The symptoms gradually improved with immunotherapy and we were able 
      to completely withdraw her from the ventilator after a few months. There were 
      some reports that dysphagia and dysarthria present suddenly like stroke without 
      fluctuation of symptoms in elderly-onset MG. It is necessary to note that MG 
      diagnosis may be difficult if elderly patients have multiple comorbidities and 
      unclear diurnal fluctuations.
FAU - Yamaguchi, Yuka
AU  - Yamaguchi Y
AD  - Department of Neurology, Sasebo City General Hospital.
FAU - Fujimoto, Takeshi
AU  - Fujimoto T
AD  - Department of Neurology, Sasebo City General Hospital.
FAU - Hayashi, Nobutaka
AU  - Hayashi N
AD  - Department of Neurology, Sasebo City General Hospital.
AD  - Department of Neurology and Strokology, Nagasaki University Hospital.
FAU - Torimura, Daiji
AU  - Torimura D
AD  - Department of Neurology, Sasebo City General Hospital.
FAU - Maeda, Yasuhiro
AU  - Maeda Y
AD  - Department of Neurology, Sasebo City General Hospital.
FAU - Tsujino, Akira
AU  - Tsujino A
AD  - Department of Neurology and Strokology, Nagasaki University Hospital.
LA  - jpn
PT  - Case Reports
PT  - Journal Article
PT  - Review
DEP - 20210325
PL  - Japan
TA  - Rinsho Shinkeigaku
JT  - Rinsho shinkeigaku = Clinical neurology
JID - 0417466
RN  - 0 (Biomarkers)
RN  - EC 2.7.10.1 (Protein-Tyrosine Kinases)
SB  - IM
MH  - Age Factors
MH  - Aged, 80 and over
MH  - Biomarkers/metabolism
MH  - Brain/diagnostic imaging
MH  - Deglutition Disorders/etiology
MH  - Diagnosis, Differential
MH  - Dysarthria/etiology
MH  - Female
MH  - Humans
MH  - Immunotherapy
MH  - Magnetic Resonance Imaging
MH  - Muscle, Skeletal/metabolism
MH  - Myasthenia Gravis/complications/*diagnosis/therapy
MH  - Paresis
MH  - Protein-Tyrosine Kinases/*metabolism
MH  - Respiration, Artificial
MH  - Respiratory Insufficiency/etiology/therapy
MH  - Stroke
MH  - Upper Extremity
OTO - NOTNLM
OT  - MuSK antibodies
OT  - dysarthria
OT  - myasthenia gravis
OT  - respiratory failure
OT  - stroke mimic
EDAT- 2021/03/26 06:00
MHDA- 2021/09/23 06:00
CRDT- 2021/03/25 05:53
PHST- 2021/03/26 06:00 [pubmed]
PHST- 2021/09/23 06:00 [medline]
PHST- 2021/03/25 05:53 [entrez]
AID - 10.5692/clinicalneurol.cn-001523 [doi]
PST - ppublish
SO  - Rinsho Shinkeigaku. 2021 Apr 21;61(4):234-238. doi: 
      10.5692/clinicalneurol.cn-001523. Epub 2021 Mar 25.