[Distal myasthenia gravis: case report].
We report the case of a 30-year-old woman with a 7-year history of distal lower limbs weakness that evolved to upper limbs weakness. On neurological examination, she presented normal cranial nerves, bilateral quadriceps and feet interosseous atrophy, normal muscular tonus, muscular weakness more severe in dorsal feet interosseous and anterior tibial, and decreased deep tendon reflexes. Repetitive nerve stimulation of the ulnar and fibular nerves showed a decrement greater than 10% of the compound muscle action potential. Antibody against acetylcholine receptor titer was positive. Computed tomography scan of the thorax was normal. Thyroid function tests showed evidence of hyperthyroidism. Distal muscular weakness is a rare onset presentation of myasthenia gravis. However, myasthenia gravis must be considered in the differential diagnosis of distal limb weakness.
Scola
Rosana Herminia
RH
Hospital de Clínicas, Universidade Federal do Parana, Curitiba, PR, Brasil. scola@hc.ufpr.br
Iwamoto
Fábio Massaiti
FM
Mainardi
Maraya Annaai Michels
MA
Della-Coletta
Marcus Vinicius
MV
Carvalho
Gisah
G
Zavala
Jorge Augusto
JA
Werneck
Lineu Cesar
LC
D000328:Adult; D003937:Diagnosis, Differential; D004558:Electric Stimulation / Q000379:methods; D005260:Female; D006801:Humans; D007866:Leg; D009119:Muscle Contraction; D018908:Muscle Weakness / Q000175:diagnosis / Q000209:etiology*; D009157:Myasthenia Gravis / Q000150:complications* / Q000175:diagnosis
Miastenia grave distal: relato de caso.