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Published in: Journal of Medical Case Reports 1/2010

Open Access 01-12-2010 | Case report

Efficacy of postural techniques assessed by videofluoroscopy for myasthenia gravis with dysphagia as the presenting symptom: a case report

Authors: Hui-Chun Juan, Isabel Tou, Shu-Chen Lo, I-Hsien Wu

Published in: Journal of Medical Case Reports | Issue 1/2010

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Abstract

Introduction

Oropharyngeal weakness leading to dysphagia is rarely the presenting symptom of myasthenia gravis, but it can be a significant source of morbidity and mortality. The earliest possible diagnosis of myasthenia gravis should be made for better management of this cause of treatable dysphagia. A detailed evaluation of swallowing by videofluoroscopy can assist in making an accurate diagnosis and in individualizing appropriate diet compensatory techniques.

Case presentation

We present the case of a 57-year-old Taiwanese man with dysphagia as the presenting symptom of myasthenia gravis, and evaluate the pathological findings of swallowing and effectiveness of compensatory postural techniques for dysphagia using videofluoroscopy.

Conclusions

Videofluoroscopy is a valuable technique for evaluating myasthenia gravis dysphagia, because it allows swallowing interventions to be precisely individualized in accordance with the results obtained.
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Literature
1.
go back to reference Engel AG: Myasthenia gravis and myasthenic syndromes. Ann Neurol. 1984, 16: 519-534. 10.1002/ana.410160502.CrossRefPubMed Engel AG: Myasthenia gravis and myasthenic syndromes. Ann Neurol. 1984, 16: 519-534. 10.1002/ana.410160502.CrossRefPubMed
2.
go back to reference Thomas CE, Mayer SA, Gungor Y, Swarup R, Webster EA, Chang I, Brannagan TH, Fink ME, Rowland LP: Myasthenic crisis: clinical features, mortality, complications, and risk factors for prolonged intubation. Neurology. 1997, 48: 1253-1260.CrossRefPubMed Thomas CE, Mayer SA, Gungor Y, Swarup R, Webster EA, Chang I, Brannagan TH, Fink ME, Rowland LP: Myasthenic crisis: clinical features, mortality, complications, and risk factors for prolonged intubation. Neurology. 1997, 48: 1253-1260.CrossRefPubMed
3.
go back to reference Palmer JB, Monahan DM, Matsuo K: Rehabilitation of patients with swallowing disorders. Physical Medicine and Rehabilitation. Edited by: Braddom RL. 2007, Philadelphia, PA: Elsevier Inc, 597-616. 3 Palmer JB, Monahan DM, Matsuo K: Rehabilitation of patients with swallowing disorders. Physical Medicine and Rehabilitation. Edited by: Braddom RL. 2007, Philadelphia, PA: Elsevier Inc, 597-616. 3
4.
go back to reference Huang MH, King KL, Chien KY: Esophageal manometric studies in patients with myasthenia gravis. J Thorac Cardiovasc Surg. 1988, 95: 281-285.PubMed Huang MH, King KL, Chien KY: Esophageal manometric studies in patients with myasthenia gravis. J Thorac Cardiovasc Surg. 1988, 95: 281-285.PubMed
5.
go back to reference Grob D, Arsura EL, Brunner NG, Namba T: The course of myasthenia gravis and therapies affecting outcome. Ann N Y Acad Sci. 1987, 505: 472-499. 10.1111/j.1749-6632.1987.tb51317.x.CrossRefPubMed Grob D, Arsura EL, Brunner NG, Namba T: The course of myasthenia gravis and therapies affecting outcome. Ann N Y Acad Sci. 1987, 505: 472-499. 10.1111/j.1749-6632.1987.tb51317.x.CrossRefPubMed
6.
go back to reference Rison RA: Reversible oropharyngeal dysphagia secondary to cricopharyngeal sphincter achalasia in a patient with myasthenia gravis: a case report. Cases J. 2009, 2: 6565-10.4076/1757-1626-2-6565.CrossRefPubMedPubMedCentral Rison RA: Reversible oropharyngeal dysphagia secondary to cricopharyngeal sphincter achalasia in a patient with myasthenia gravis: a case report. Cases J. 2009, 2: 6565-10.4076/1757-1626-2-6565.CrossRefPubMedPubMedCentral
7.
go back to reference Colton-Hudson A, Koopman WJ, Moosa T, Smith D, Bach D, Nicolle M: A prospective assessment of the characteristics of dysphagia in myasthenia gravis. Dysphagia. 2002, 17: 147-151. 10.1007/s00455-001-0114-4.CrossRefPubMed Colton-Hudson A, Koopman WJ, Moosa T, Smith D, Bach D, Nicolle M: A prospective assessment of the characteristics of dysphagia in myasthenia gravis. Dysphagia. 2002, 17: 147-151. 10.1007/s00455-001-0114-4.CrossRefPubMed
8.
go back to reference Cook IJ, Kahrilas PJ: AGA technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999, 116: 455-478. 10.1016/S0016-5085(99)70144-7.CrossRefPubMed Cook IJ, Kahrilas PJ: AGA technical review on management of oropharyngeal dysphagia. Gastroenterology. 1999, 116: 455-478. 10.1016/S0016-5085(99)70144-7.CrossRefPubMed
9.
go back to reference Warnecke T, Teismann I, Zimmermann J, Oelenberg S, Ringelstein EB, Dziewas R: Fiberoptic endoscopic evaluation of swallowing with simultaneous Tensilon application in diagnosis and therapy of myasthenia gravis. J Neurol. 2008, 255: 224-230. 10.1007/s00415-008-0664-6.CrossRefPubMed Warnecke T, Teismann I, Zimmermann J, Oelenberg S, Ringelstein EB, Dziewas R: Fiberoptic endoscopic evaluation of swallowing with simultaneous Tensilon application in diagnosis and therapy of myasthenia gravis. J Neurol. 2008, 255: 224-230. 10.1007/s00415-008-0664-6.CrossRefPubMed
10.
go back to reference Schwartz DC, Waclawik AJ, Ringwala SN, Robbins J: Clinical utility of videofluorography with concomitant Tensilon administration in the diagnosis of bulbar myasthenia gravis. Dig Dis Sci. 2005, 50: 858-861. 10.1007/s10620-005-2653-2.CrossRefPubMed Schwartz DC, Waclawik AJ, Ringwala SN, Robbins J: Clinical utility of videofluorography with concomitant Tensilon administration in the diagnosis of bulbar myasthenia gravis. Dig Dis Sci. 2005, 50: 858-861. 10.1007/s10620-005-2653-2.CrossRefPubMed
Metadata
Title
Efficacy of postural techniques assessed by videofluoroscopy for myasthenia gravis with dysphagia as the presenting symptom: a case report
Authors
Hui-Chun Juan
Isabel Tou
Shu-Chen Lo
I-Hsien Wu
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2010
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-4-370

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