title: Myasthenia gravis with presynaptic neurophysiological signs: Two case reports and literature review.
abstract: The distinction between myasthenia gravis and Lambert-Eaton myasthenic syndrome is based on clinical, neurophysiological and immunological features. We hereby report two cases with a clinical diagnosis of myasthenia gravis and neurophysiological features consistent with a pre-synaptic neuromuscular transmission defect. Both patients had increased anti-acetylcholine receptor antibody titres and showed a good response to cholinesterase inhibitors, along with a >100% facilitation of the compound muscle action potential on electrophysiological studies. We provide a review of English literature studies on co-existing features of myasthenia gravis and Lambert-Eaton myasthenic syndrome, and discuss diagnostic controversies.
authors.affiliation: Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: paoloemilio.alboini84@gmail.com.
authors.forename: Paolo Emilio
authors.initials: PE
authors.lastname: Alboini
authors.affiliation: Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Damato
authors.affiliation: Don Carlo Gnocchi ONLUS Foundation, Milan, Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Iorio
authors.affiliation: Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Luigetti
authors.affiliation: Institute of Neurology, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: Amelia
authors.initials: A
authors.lastname: Evoli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000906:Antibodies; D005260:Female; D006801:Humans; D015624:Lambert-Eaton Myasthenic Syndrome / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D018908:Muscle Weakness; D009157:Myasthenia Gravis / Q000175:diagnosis* / Q000503:physiopathology; D009431:Neural Conduction; D009469:Neuromuscular Junction; D010543:Peroneal Nerve / Q000503:physiopathology; D017729:Presynaptic Terminals / Q000502:physiology; D011950:Receptors, Cholinergic / Q000276:immunology; D009435:Synaptic Transmission; D055815:Young Adult
chemical_list: D000906:Antibodies; D011950:Receptors, Cholinergic
keywords: 3,4-Diaminopyridine; Cholinesterase inhibitors; Lambert–Eaton myasthenic syndrome; Myasthenia gravis; Presynaptic neurophysiological pattern