• Title/Summary/Keyword: 중증근무력증

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A Case of Myasthenia Gravis Diagnosed by Repetitive Hypoglossal Nerve Stimulation Test (반복 설하신경 자극검사로 진단한 중증근무력증 1예)

  • Jang, Il-Mi;Lee, Kyung-Bok;Roh, Hakjae;Ahn, Moo-Young;Yang, Kwang-Ik;Sung, Ki-Bum
    • Annals of Clinical Neurophysiology
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    • v.8 no.1
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    • pp.74-77
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    • 2006
  • Repetitive nerve stimulation is a simple and widely used technique to demonstrate neuromuscular transmission defect. A significant decremental response for repetitive hypoglossal nerve stimulation was obtained from the surface recordings in the tongue of a patient with dysarthria and dysphagia. Repetitive hypoglossal nerve stimulation test may be useful in diagnosis of myasthenia gravis with bulbar symptoms only. We utilized repetitive hypoglossal nerve stimulation with tongue recordings and diagnosed a case of myasthenia gravis.

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A Case of Myasthenia Gravis Associated with Alopecia Areata (원형탈모증과 동반된 중증근무력증 1예)

  • Han, Gwangsu;Lee, Kyu-Yong;Lee, Young Joo
    • Annals of Clinical Neurophysiology
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    • v.7 no.1
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    • pp.58-60
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    • 2005
  • Myasthenia gravis (MG) is occasionally associated with other autoimmune diseases. Alopecia areata has been reported to coincide with MG, particularly with thymoma. A 14-year-old woman was diagnosed as having MG. Seven months before diagnosed with MG, her hair and eyebrows had began to disappear and alopecia areata was diagnosed. We report this patient as a rare case of MG associated with alopecia areata without thymoma.

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Immunosuppressive Therapy for Autoimmune Myasthenia Gravis (자가면역 중증근무력증의 면역억제요법)

  • Kim, Su-Yeon;Hong, Yoon-Ho
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.51-58
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    • 2007
  • Autoimmune myasthenia gravis (MG) is the neuromuscular junction disorder mostly caused by antibody against the acetylcholine receptor (AChR antibody) at the muscle endplate. The goal of treatment is to induce and maintain remission, i.e., absence of symptoms, with the least cost-to-benefit ratio. Although corticosteroids are effective in inducing remission in most patients, they have numerous potentially serious adverse effects with their long-term use. In addition, some patients do not respond or are intolerant to the conventional treatment. In this article, we discuss the difficulties encountered in long-term immunosuppressive treatment of MG, and review useful tips for the use of corticosteroids. Long-term immunosuppressive agents that can be used in steroid-refractory or -dependent patients will be reviewed with their safety profiles and efficacy in MG.

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A Case Study on the Alleviation of Symptom of a Myasthenia Gravis Patient after Korean Medicine Treatment (중증근무력증이 한의학적 치료로 개선된 임상 1례)

  • Bae, Young-chun;Park, Soo-jung
    • The Journal of Internal Korean Medicine
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    • v.40 no.1
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    • pp.136-144
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    • 2019
  • Objective: The purpose of this study was to report on the alleviation of symptoms of a myasthenia gravis (MG) patient after Korean medicine treatment. Methods: A 39 year-old male patient who suffered from MG was examined. The patient was treated with herbal medicine, acupuncture, and pharmacopuncture. The Myasthenia Gravis Composite (MGC) scale and Myasthenia Gravis Activities of Daily Living (MG-ADL) profile were used to assess the change of MG symptoms after Korean medicine treatment. Results: The MGC and MG-ADL scores indicated significant improvement after 14 days of treatment. In addition, the degrees of fatigue, dyspepsia, vomiting, sweating, and dizziness were decreased. Conclusion: This study may suggest that Korean medicine treatment could be effective in treating the symptoms of MG.

Surgical Treatment of Thymoma (흉선종의 수술치료)

  • 홍치욱;박주철
    • Journal of Chest Surgery
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    • v.30 no.1
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    • pp.61-66
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    • 1997
  • Between January 1986 and December 1995, 24 patients were treated surgically for thymoma. There were 17 males and 7 females, and their ages ranged from 23 to 69 years old and mean age was 49 years. Thymomas ere associated with fourteen myasthenia gravid, and classified histologically as Iymphocytic in 12 patients, mixed in 8, epithelial in 4, and classified clinically as stage I in 11, stage II in 4, stage III in 8 and stage VI in 1 patient. Eleven patients with non-invasive thymoma had received surgical resection, and 10 out of 13 patients with invasive thymoma were able to undergo complete resection. A partial resection or tissue biopsy followed by radiation or chemotherapy was done with the remaining three patients. Three died, four had improvement of symptom, two had relapse and fifteen had no symptom during follow up ranged from 25 days to 60 months. In fourteen cases of thymoma with myasthenia gravid, one died due to myasthenic crisis, two showed symptom aggravation, six had less medical treatment and five patients had medical treatment as same as dosage received preoperatively.

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A Case Report of Korean Medical Intervention in a Patient with Myasthenia Gravis after Myasthenia Crisis (근무력증 위기를 겪은 중증근무력증 환자의 한의학적 중재에 관한 증례보고 1례)

  • Kim, Yeseul;Park, Jiyoon;Min, Seonwoo;Moon, Jiseong;Hong, Junghwa;Ahn, Lib;Choi, Dongjun
    • The Journal of Internal Korean Medicine
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    • v.43 no.2
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    • pp.244-253
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    • 2022
  • Objective: This study reports on the management of a patient with myasthenia gravis (MG) following myasthenic crisis (MC) using Korean medicine. Methods: A 77-year-old Class V MG patient was treated with acupuncture, moxibustion, and Korean herbal medicine. A manual muscle test was used to derive a Medical Research Council (MRC) score and the patient's subjective view of his dyspnea was measured to assess MG symptoms. Results: The MRC grade indicated significant deterioration after 65 days of treatment, although there was no change in the patient's subjective dyspnea assessment. But no other MG or MC complications occurred. Conclusion: This study suggests that Korean medicine could be used for the management of Class V MG patients.

Guillain-Barré Syndrome in a Patient with Myasthenia Gravis (중증근무력증 환자에서 발생한 길랑-바레 증후군 1례)

  • Seo, Soo Kun;Park, Moon Ho;Park, Beom Sick;Kim, Byung Jo;Park, Min Gyu;Park, Gun Woo;Lee, Dae Hie
    • Annals of Clinical Neurophysiology
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    • v.2 no.2
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    • pp.135-138
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    • 2000
  • Both myasthenia gravis and Guillain-$Barr{\acute{e}}$ syndrome are autoimmune disorder, but it is very rare that both of them occur together. A 53-year old woman with history of myathenia gravis complained of weakness of extremities, worsening progressively for several days. Electrophysiologic study showed findings of motor axonal neuropathy without sensory involvement. She became improved in aspect of clinical symtoms and electrophysiologic findings after infusion of immunoglobulin. This is a case of Guillain-$Barr{\acute{e}}$ syndrome in a patient with myasthenia gravis.

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Clinical study of Myasthenia Gravis associated with other autoimmune diseases (자가면역질환과 동반된 중증근무력증의 임상적 연구)

  • Kim, Byung Jo;Koh, Seong Beom;Park, Min Kyu;Park, Kun Woo;Lee, Dae Hie
    • Annals of Clinical Neurophysiology
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    • v.3 no.1
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    • pp.21-25
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    • 2001
  • Background & Object : Myasthenia gravis(MG) is an autoimmune disease due to binding of antibody to acetylcholine receptors on the muscle membrane. It is well known that other autoimmune diseases infrequently accompany myasthenia gravis. The aim of this study was to evaluate the clinical significance of associated autoimmune diseases(AAD) and compare prognosis between MG with AAD and MG without AAD. Method : A total of 65 MG patients(24 men and 41 women) were enrolled at this study. From the clinical records of these patients, we investigated the clinical characteristics and prognosis of MG with AAD and compared these data with those of MG without other such diseases. Results : AAD were found in 10 of 65 cases(15%). 9 cases of 10 MG with AAD were generalized MG type. The most common disease was thyroid disorder. The rate of AAD was higher in thymic abnormal patients. There was no significant remission rate difference between MG with AAD and MG without AAD, but the percentage of patients experienced crisis was higher in MG with AAD. Conclusion : The occurrence of AAD may suggest a more generalized autoimmune disturbance that could be associated with a less favorable prognosis.

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Megaoesophagus Seconday to Myasthenia Gravis in Three Dogs (중증근무력증에 의한 개의 거대식도증 3례)

  • Lee, Hee-Chun;Jeon, Joon-Hyeok;Cho, Kyu-Woan;Kang, Byeong-Teck;Jung, Dong-In
    • Journal of Veterinary Clinics
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    • v.29 no.1
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    • pp.107-111
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    • 2012
  • Three dogs (An 8 years-old intact female Poodle, a 7 years-old intact male Schunauzer, and an 8 yearsold Golden Retriever) were presented due to acute vomiting, dyspnea, and generalized weakness. Megaesophagus was confirmed through radiographic examination in all 3 dogs. Relative oesophageal diameter (ROD) was measured and results of ROD measurements showed the possibility of megaesophagus secondary to myasthenia gravis in three dogs. Thus we performed anticholinesterase test as screening test for myasthenia gravis. In all three dogs, esophageal diameter was reduced after neostigmine methylsulfate administration. For definite diagnosis of acquired myasthenia gravis, serum acetylcholine receptor antibody titer was measured, but definite diagnosis was confirmed only in one case. However, based on history, radiographic findings, anticholinesterase test, ROD measurement, other two cases were still suspected as megaesophagus secondary to myasthenia gravis. Treatment with pyridostigmine bromide was initiated in all dogs, and improvement of esophageal diameter was shown in all dogs. One dog was successfully managed for 15 months after initial treatment and, is still alive, but other two dogs were died shortly after initial treatment, because of severe aspiration pneumonia.

A Clinical Study on Bilateral Vocal Fold Paralysis (양측성대마비에 대한 임상적 고찰)

  • 김광문;최홍식;최흥식;조정일;김세헌
    • Proceedings of the KSLP Conference
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    • 1996.11a
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    • pp.84-84
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    • 1996
  • 1986년 10월부터 1996년 8월까지 연세대학교 의과대학 영동세브란스병원 이비인후과에 내원한 환자로서 문진, 이학적검사 및 방사선학적검사에 의하여 양측성대마비로 진단된 47례를 대상으로 성별, 연령, 주증상, 성대마비의 원인 및 치료경과에 대하여 후향적으로 분석하였다. 성별은 남자가 34례(72%), 여자가 13례(28%)였고 연령별로는 20대에서 60대에 걸쳐 비교적 고르게 분포하였으며 평균연령은 46세였다. 주증상이 호흡곤란이었던 경우가 22례(47%)로 가장 많았고 애성이 19례(40%)로 그 다음 순이었다. 성대마비의 원인별로 보면, 중추성이 4례(9%)였고, 나머지는 말초성으로 이중 비수술적 외상에 의한 경우가 15례(32%)로 가장 많았고 수술적 외상이 10례(21%), 특발성이 9례(19%), 기도내 삽관이 5례(11%)였으며, 이외에도 염증성요인에 의한 것이 2례, 갑상선종양에 의한 것이 1례, 그리고 중증근무력증에 의한 것이 1례이었다. 양측성대마비에 대한 치료로서 기관절개술이 13례(28%), 피열연골절제술이 13례(28%)에서 행해졌으며 이중 술후 완전탈관이 가능하였던 경우는 기관절개술을 시행하였던 경우에 6례(46%), 피열연골절제술을 시행하였던 경우에 9례(69%)였고 수술후 완전탈관까지의 기간은 기관절개술의 경우 평균 18개월, 피열연골절제술의 경우 평균 3개월이었다. 이외 보존적 치료가 20례(43%)에서 행해졌으며 이중 2례는 자연치유되었다.

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