title: Clinical utility of videofluorography with concomitant Tensilon administration in the diagnosis of bulbar myasthenia gravis.
abstract: Myasthenia gravis (MG) classically presents with ocular, bulbar, and predominantly proximal muscle weakness. Isolated bulbar symptoms occur in less than 25% of cases and can mimic stroke (1-3). If left untreated, MG can lead to significant morbidity and mortality, including myasthenic crisis and recurrent aspiration pneumonia. We describe a case of a 68-year-old man who presented with isolated bulbar symptoms. We used a novel approach to diagnosis which included a videofluorographic swallow study with concomitant Tensilon (edrophonium) injection.
authors.affiliation: Department of Medicine, Section of Gastroenterology & Hepatology, University of Wisconsin Medical School, Madison, Wisconsin, USA.
authors.forename: Darren C
authors.initials: DC
authors.lastname: Schwartz
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Waclawik
authors.forename: Sumit N
authors.initials: SN
authors.lastname: Ringwala
authors.forename: Joanne
authors.initials: J
authors.lastname: Robbins
mesh_terms: D000200:Action Potentials; D000368:Aged; D002800:Cholinesterase Inhibitors; D003679:Deglutition / Q000502:physiology*; D004491:Edrophonium; D005154:Facial Nerve / Q000503:physiopathology*; D005471:Fluoroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D018482:Muscle, Skeletal / Q000503:physiopathology; D009157:Myasthenia Gravis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D014741:Video Recording
chemical_list: D002800:Cholinesterase Inhibitors; D004491:Edrophonium