title: Detectable voice change with the edrophonium test in laryngeal myasthenia gravis.
abstract: A case of laryngeal myasthenia gravis in a 65-year-old woman presenting with hoarseness as the sole symptom is reported. Voice spectrography was performed before and after injection of intravenous edrophonium. There was a marked improvement in the patient's voice after the administration of edrophonium, which was confirmed by the changes seen on the sound spectrogram. This was the only objective indication of a diagnosis of myasthenia gravis. No thymoma was seen on chest X-ray and the patient was negative for anti-acetylcholine receptor antibodies. Treatment for laryngeal myasthenia gravis was initiated and the patient's vocal problems resolved. This case emphasizes the need to consider systemic diseases in the differential diagnosis of hoarseness and demonstrates the need for careful follow-up in such patients.
authors.affiliation: 1 National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Tsunoda
authors.affiliation: 1 National Institute of Sensory Organs, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Fujimaki
authors.affiliation: 2 Department of Neurology, National Hospital Organization Tokyo Medical Center, Tokyo, Japan.
authors.forename: Yoko
authors.initials: Y
authors.lastname: Morita
mesh_terms: D000368:Aged; D004491:Edrophonium / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D007830:Larynx / Q000187:drug effects / Q000473:pathology* / Q000503:physiopathology*; D009157:Myasthenia Gravis / Q000188:drug therapy* / Q000503:physiopathology*; D013018:Sound Spectrography; D014831:Voice / Q000187:drug effects
chemical_list: D004491:Edrophonium
keywords: Hoarseness; diagnosis; edrophonium test; myasthenia gravis; sound spectrography