Very Late-Onset Myasthenia Gravis Presenting With Dysphagia and Gradual Decrease in Laryngeal Elevation During Repeated Swallowing: A Case Report
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Summary
This summary is machine-generated.Very late-onset myasthenia gravis (VLOMG) can present as isolated swallowing difficulties in individuals over 65. Early recognition of symptoms like dysphagia and reduced laryngeal elevation is crucial for timely diagnosis and management.
Area Of Science
- Neurology
- Geriatrics
- Gastroenterology
Background
- Very late-onset myasthenia gravis (VLOMG) is a rare subtype of myasthenia gravis (MG) characterized by onset after age 65.
- Dysphagia and dysarthria are common presenting symptoms in MG, but can be isolated in VLOMG.
Purpose Of The Study
- To highlight the importance of considering VLOMG in elderly patients presenting with specific swallowing abnormalities.
- To describe a case of VLOMG presenting with isolated dysphagia.
Main Methods
- Case report of a 72-year-old patient with dysphagia.
- Diagnostic evaluation included upper gastrointestinal radiography.
- Serological testing for anti-acetylcholine receptor (anti-AChR) antibodies.
Main Results
- Upper GI radiography showed delayed pharyngeal swallowing initiation and inadequate upper esophageal sphincter opening.
- A gradual decrease in laryngeal elevation during swallowing was observed, suggestive of MG.
- The patient tested positive for anti-AChR antibodies and experienced type I respiratory failure requiring ventilatory support.
Conclusions
- VLOMG should be suspected in patients over 65 with sudden, isolated dysphagia or dysarthria.
- Characteristic radiographic findings, such as reduced laryngeal elevation, can aid in diagnosis.
- Prompt recognition and management are essential for improving patient outcomes.
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