title: Perineurial cell ensheathement of muscle fibers: a new syndrome of fatigable muscle weakness mimicking myasthenia gravis.
abstract: Many newly discovered pathological and physiological variants of neuromuscular junction function have been identified. We report a case of a myasthenia gravis-like syndrome with onset of ptosis at age six years and eventual evaluation for peripheral weakness twenty years later. Subsequent muscle biopsy showed a previously unreported finding of perineurial cell ensheathement of the muscle fibers. We suggest that the ensheathement of the muscle cells by perineurial cells may alter the microenvironment interfering with neuromuscular transmission.
authors.affiliation: Department of Neurology, University of Oklahoma Health Sciences Center, Oklahoma City 73190.
authors.forename: M L
authors.initials: ML
authors.lastname: Michaelis
authors.forename: J A
authors.initials: JA
authors.lastname: King
authors.forename: R W
authors.initials: RW
authors.lastname: Leech
authors.forename: K W
authors.initials: KW
authors.lastname: Min
authors.forename: R A
authors.initials: RA
authors.lastname: Brumback
mesh_terms: D000328:Adult; D003238:Connective Tissue / Q000473:pathology; D003937:Diagnosis, Differential; D005221:Fatigue / Q000473:pathology*; D006801:Humans; D008297:Male; D009132:Muscles / Q000473:pathology*; D009135:Muscular Diseases / Q000175:diagnosis / Q000473:pathology*; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000473:pathology*; D013577:Syndrome