title: Late onset generalized myasthenia gravis presenting with facial weakness and bulbar signs without extraocular muscle involvement.
abstract: Bilateral facial palsy is a common sign of autoimmune myasthenia gravis (MG). However, facial muscle weakness without clinical signs of extraocular muscle (EOM) involvement is extremely rare. We describe a late onset generalized MG presenting with facial weakness and bulbar signs without EOM deficits. The diagnosis was based on neurophysiological assessment and positive acetylcholine receptor antibody titer. Thymoma was excluded. The clinical response to corticosteroids, pyridostigmine and intravenous immunoglobulin was complete. EOM weakness was never observed during a 3-year follow-up, also during a later exacerbation of MG.
authors.affiliation: Dipartimento di Neuroscienze, Università degli Studi di Parma, Parma, Italy. cucurachi77@yahoo.com
authors.forename: Laura
authors.initials: L
authors.lastname: Cucurachi
authors.forename: Luigi
authors.initials: L
authors.lastname: Cattaneo
authors.forename: Franco
authors.initials: F
authors.lastname: Gemignani
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pavesi
mesh_terms: D000200:Action Potentials / Q000502:physiology; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003680:Deglutition Disorders / Q000209:etiology; D055154:Dysphonia / Q000209:etiology; D004558:Electric Stimulation; D005152:Facial Muscles / Q000503:physiopathology*; D005154:Facial Nerve / Q000502:physiology; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D008297:Male; D018908:Muscle Weakness / Q000209:etiology / Q000503:physiopathology*; D009157:Myasthenia Gravis / Q000150:complications* / Q000503:physiopathology; D011241:Prednisone / Q000627:therapeutic use; D011729:Pyridostigmine Bromide / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D002800:Cholinesterase Inhibitors; D016756:Immunoglobulins, Intravenous; D011729:Pyridostigmine Bromide; D011241:Prednisone