ABSTRACT
A review of the literature covering the issues of etiology, pathogenesis, variety of atypical forms, diagnosis and management of patients with neuralgic amyotrophy is presented.
Subject(s)
Brachial Plexus Neuritis , Brachial Plexus Neuritis/diagnosis , Brachial Plexus Neuritis/therapy , HumansABSTRACT
Thymectomy and removal of the hyperplastic thymus have been performed in 21 patients with myasthenia. In 14 patients, thymectomy is performed through thoracoscopic access (TA), while in 7 cases through thoracotomic access (TT). The serum levels of antibodies to acetylcholine receptors (AChR) determined before and after surgery were increased in both groups of patients. Thus, thymectomy, regardless of the degree of clinical improvement in early post operative period, significantly increases the level of anti-AChR antibodies in the serum of patients in the early postoperative period compared to baseline. These changes may reflect the immune response to a stressful situation related to the traumatic surgery. It should be noted that the level of anti-AChR antibodies was significantly higher in a group of TT that may be related with a larger volume of the removed tissue.
Subject(s)
Autoantibodies/blood , Myasthenia Gravis/immunology , Myasthenia Gravis/surgery , Receptors, Cholinergic/immunology , Thymectomy , Thymus Hyperplasia/surgery , Adult , Female , Humans , Male , Middle Aged , Postpartum Period , ThoracotomyABSTRACT
The MRC scale is traditionally used for assessment of the severity of movement disorders. The patients' effort is graded on a scale of 0-5. The use of this scale is limited by subjective biases and inadequate assessment of some functions. The quantitative scale for assessment of the severity of clinical symptoms of myasthenia (QMGS) allows to evaluate pathological muscle fatigability, the main syndrome of this disease, which is important for evaluating the severity of symptoms before and after the pathogenetic treatment or when probes with the introduction of acetylcholinesterase preparations are used.
Subject(s)
Movement Disorders/physiopathology , Myasthenia Gravis/physiopathology , Severity of Illness Index , Adolescent , Adult , Aged , Humans , Male , Middle Aged , Young AdultABSTRACT
We studied anti-acetylcholine receptor antibodies (ARAb) in 25 patients with myasthenia gravis before and after the immunosuppressive drug (steroid) therapy and in 22 patients before and after thymectomy. The clinical effect after the treatment was correlated with the reduction of ARAb levels by more than 20% in 62% of patients. The ARAb levels did not change, or even increased, in 15% patients despite the improvement of their clinical state. We showed the direct correlation between the clinical improvement and the decrease of ARAb level.
