title: Pediatric myasthenia gravis and velopharyngeal incompetence.
abstract: OBJECTIVE
  To determine the clinical course of velopharyngeal incompetence in children with myasthenia gravis (MG).
  
  
  METHODS
  A 30-year retrospective study was performed using the medical records of 538 children who presented with velopharyngeal inadequacy (VPI) to a tertiary care academic pediatric center. Children with velopharyngeal incompetence due to myasthenia gravis were identified and their clinical courses were reviewed.
  
  
  RESULTS
  Four children were identified with velopharyngeal incompetence associated with myasthenia gravis. All four children required intervention for improvement of speech intelligibility. A speech prosthesis was the uniform intervention.
  
  
  CONCLUSIONS
  Neonatal myasthenia gravis patients should be followed long-term as symptoms may recur as speech impairment. In addition, a high index of suspicion for this entity is required for early diagnosis due to the highly variable presentation and clinical course.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, WI, USA.
authors.forename: Anthony A
authors.initials: AA
authors.lastname: Rieder
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Conley
authors.forename: Laura
authors.initials: L
authors.lastname: Rowe
mesh_terms: D000293:Adolescent; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D009157:Myasthenia Gravis / Q000150:complications*; D010158:Palatal Obturators; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013065:Speech Intelligibility; D013070:Speech Therapy; D014681:Velopharyngeal Insufficiency / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy