Clinical profile of myasthenia gravis in the sultanate of Oman

Clinical study and follow up of myasthenia gravis patients in Oman. Follow up of 50 consecutive myasthenia gravis patients referred to the Sultan Qaboos University Hospital, Oman for a median period of 3 years from 1997 to 2000. We based the diagnosis on the clinical picture, repetitive nerve stimulation tests and edrophonium test. We performed a computerized tomography scan of the chest and anti-acetylcholine receptor antibodies. We reviewed the results of immuno modulatory treatment including thymectomy and compared these with other studies. Of 50 patients, 6 had purely ocular myasthenia. Of the 44 with generalized myasthenia, 28 had bulbar involvement and 12 required ventilatory support. Eight out of 29 thymectomized patients had drug free remission after 2 years. There was worsening of myasthenic symptoms in only one out of 8 pregnancies and deliveries. Bulbar and ventilatory involvement are more common in our series as compared with western data. Pregnancy and delivery were well tolerated

Hypernatremic metabolic myopathy due to hypothalamic dysfunction

We report a patient with muscle weakness secondary to elevated serum sodium level. The cause of the elevated sodium level and the mechanism involved in producing muscle weakness are discussed

Fatal cerebral infarction in neurofibromatosis type I

Neurofibromatosis is a relatively common genetic disorder with a prevalence of approximately 1 per 3000 population [1]. Although cerebrovascular accidents are recognized in this condition, they are relatively rare. We report the case of a young man with neurofibromatosis type 1, who sustained massive cerebral infarction