Myasthenia mimicking vertebrobasilar stroke.
The advent of thrombolysis has offered a remarkable opportunity for treatment of acute ischemic stroke. Other therapies involving neuro-protection may be forthcoming. These treatments, however, are not without risk, making accurate diagnosis of stroke all the more important. Several conditions may mimic stroke in the emergency department, with myasthenia being an uncommon stroke mimic. We present two cases of myasthenia presenting as posterior circulation stroke. In one case, the tempo suggested basilar thrombosis. Treatment decisions regarding thrombolysis for stroke must be made rapidly. Stroke mimics continue to present a diagnostic challenge, myasthenia included. Accurate diagnosis is essential to avoid unnecessary hazard, as well as to implement effective treatment for the appropriate diagnosis.
Libman
Richard
R
The Department of Neurology, Long Island Jewish Medical Center, The Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, New York 11040, USA. libman@lij.EDU
Benson
Richard
R
Einberg
Kenneth
K
D000368:Aged; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D020526:Brain Stem Infarctions / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D010956:Plasmapheresis; D011729:Pyridostigmine Bromide / Q000627:therapeutic use; D013945:Thymoma / Q000150:complications / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014715:Vertebrobasilar Insufficiency / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy
D006493:Heparin; D011729:Pyridostigmine Bromide