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Related Concept Videos

Myasthenia Gravis ll: Pathophysiology01:22

Myasthenia Gravis ll: Pathophysiology

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The disease process of myasthenia gravis begins at the neuromuscular junction, where antibodies attack key proteins needed for muscle activation. This immune reaction weakens signal transmission, leading to the characteristic muscle fatigue and weakness that define the condition.Immune-Mediated DamageIn most individuals, antibodies target acetylcholine receptors (AChRs) on the postsynaptic membrane of muscle cells. By blocking acetylcholine binding, these antibodies prevent the nerve signal...
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Alterations in Muscle Tone lll01:11

Alterations in Muscle Tone lll

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Rigidity and myotonia are distinct abnormalities of muscle tone that affect resistance and relaxation during movement. Although both involve altered muscle contraction, they arise from different neurological and muscular mechanisms.CharacteristicsRigidity is characterized by uniform resistance to passive movement across the entire range, independent of speed, affecting flexors and extensors equally. It may appear as lead-pipe rigidity (smooth, constant resistance) or cogwheel rigidity...
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Parkinson Disease ll: Pathophysiology01:24

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Parkinson disease (PD) is a progressive neurodegenerative disorder primarily affecting movement, with additional non-motor features. Its pathophysiology involves complex interactions among genetic susceptibility, environmental exposures, and cellular dysfunction, including dopaminergic neuron loss, protein aggregation, and mitochondrial impairment.Selective NeurodegenerationA key feature is the degeneration of dopaminergic neurons in the substantia nigra pars compacta, leading to reduced...
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Multiple Sclerosis l: Introduction01:19

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Multiple sclerosis is a chronic autoimmune disease of the central nervous system (CNS) that affects the brain, spinal cord, and optic nerves. It is an inflammatory demyelinating disorder and a leading cause of neurological disability in young adults.EpidemiologyMS commonly begins between 20 and 40 years of age and is twice as common in women. Its exact cause remains unclear, but genetic susceptibility contributes, with higher risk in first-degree relatives and identical twins. A greater...
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Alterations in Muscle Tone ll01:12

Alterations in Muscle Tone ll

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Alterations in muscle tone are common manifestations of neurological disorders and reflect dysfunction within different nervous system regions. Spasticity, paratonia, and dystonia represent distinct forms of hypertonia, each with unique mechanisms, clinical features, and diagnostic importance.CharacteristicsSpasticity happens from upper motor neuron lesions and is characterized by velocity-dependent resistance to passive movement. Clinical features include:Exaggerated deep tendon reflexesClonus...
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Myasthenia Gravis: Diagnostic Tests01:15

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Myasthenia gravis is an autoimmune condition affecting neuromuscular transmission, causing generalized weakness in skeletal muscles. Initial diagnoses rely on patients' signs, symptoms, and medical history. The challenge lies in distinguishing myasthenia from other muscular dystrophies. An important diagnostic feature is the significant improvement of symptoms after administering anticholinesterase inhibitors.
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Vocal fold motion impairment in multiple system atrophy.

Ian J Lalich1, Dale C Ekbom, Sidney J Starkman

  • 1Department of Otorhinolaryngology, Mayo Clinic, Rochester, Minnesota, U.S.A.

The Laryngoscope
|October 12, 2013
PubMed
Summary

Vocal fold motion impairment (VFMI) is common in Multiple System Atrophy (MSA) and its severity impacts survival. Early otolaryngologic examination is crucial for MSA patients with voice or breathing issues.

Keywords:
Multiple system atrophyhoarsenessstridorsudden deathvocal fold motion impairment

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Area of Science:

  • Neurology
  • Otolaryngology
  • Medical Research

Background:

  • Multiple system atrophy (MSA) is a progressive neurodegenerative disorder.
  • Vocal fold mobility can be affected in MSA patients, impacting quality of life.
  • Understanding vocal fold motion impairment (VFMI) in MSA is essential for patient management.

Purpose of the Study:

  • To investigate the prevalence and impact of vocal fold motion impairment (VFMI) in patients with Multiple System Atrophy (MSA).
  • To determine the relationship between VFMI severity and overall survival in MSA patients.
  • To highlight the importance of otolaryngologic evaluation in MSA diagnosis.

Main Methods:

  • Retrospective case series analysis of MSA patients with voice or respiratory symptoms.
  • Review of otolaryngologic examination findings from 1975 to 2010.
  • Statistical analysis to correlate VFMI characteristics with survival outcomes.

Main Results:

  • Thirty-eight MSA patients exhibited VFMI, with a median symptom duration of 12 months prior to MSA diagnosis.
  • Bilateral VFMI was most common (82.4%), and TVF paralysis was associated with decreased survival (P=.0384).
  • Stridor was present in 68% of patients but did not correlate with prognosis.

Conclusions:

  • Increasing severity of VFMI negatively impacts overall survival in MSA patients.
  • Otolaryngologic examination should be performed at the time of MSA diagnosis.
  • Early identification of VFMI can inform prognosis and management strategies.