ABSTRACT
We present the case of a 33-year-old woman who within weeks developed severe swallowing difficulties and weakness in her limbs to an extent requiring hospitalization. Workup confirmed clinically suspected diagnoses of polymyositis and autoimmune myasthenia. A suspicion of malignant thymoma based on chest computed tomography was histologically verified. Patient treatment and response are presented. The case emphasizes the importance of recognizing that thymomas, in rare instances, may present with a combination of neuromuscular disorders in the same patient.
Subject(s)
Myasthenia Gravis/etiology , Polymyositis/etiology , Thymoma/complications , Thymus Neoplasms/complications , Adult , Female , Humans , Myasthenia Gravis/diagnosis , Myasthenia Gravis/therapy , Polymyositis/diagnosis , Polymyositis/pathology , Polymyositis/therapy , Thymoma/diagnostic imaging , Thymoma/drug therapy , Thymoma/surgery , Thymus Neoplasms/diagnostic imaging , Thymus Neoplasms/drug therapy , Thymus Neoplasms/surgery , Tomography, X-Ray ComputedABSTRACT
The risk of developing osteoporosis, as well as Parkinson's disease (PD) is increased with increasing age, resulting in increased risk of fracture, particularly hip fractures. Each one of these two conditions can be debilitating and affect the individual patient's quality of life negatively. PD patients have higher risk of developing osteoporosis and hip fracture compared to those without PD because of lower bone mineral density (BMD) and lack of vitamin D. Prevention of fracture in PD patients should include fall-risk screening, BMD measurements by DXA scan and screening for risk factors for osteoporosis.
Subject(s)
Osteoporosis/complications , Parkinson Disease/complications , Bone Density/physiology , Exercise , Female , Hip Fractures/etiology , Hip Fractures/physiopathology , Humans , Immobilization , Osteoporosis/drug therapy , Osteoporosis/physiopathology , Osteoporosis/prevention & control , Parkinson Disease/physiopathology , Risk Factors , Sex Factors , Vitamin D Deficiency/complicationsABSTRACT
BACKGROUND: The circle of Willis is an important source of collateral blood flow to maintain adequate cerebral perfusion, particularly in the posterior circulation. Some studies report a relationship between incomplete circle of Willis and migraine, whereas other studies show no difference between the prevalence of incomplete circle of Willis in migraineurs and controls. In the present study we compared the prevalence of incomplete circle of Willis in female migraine patients without aura to female healthy non-migraine controls.Using 3-Tesla magnetic resonance angiography we recorded three-dimensional time-of-flight angiograms in 85 female participants (48 migraine patients without aura [median age 28 years] and 37 healthy controls [median age 25 years]). The images were subsequently analysed blindly by a neuroradiologist to detect incomplete circle of Willis. FINDINGS: We found no difference between the prevalence of incomplete circle of Willis in patients, 20/47 (43%), and controls, 15/37 (41%), p = 0.252. Post hoc analysis showed a significant relationship between age and prevalence of incomplete circle of Willis, p = 0.003. CONCLUSION: We found no relationship between migraine without aura and incomplete circle of Willis.
