Details

Hits: 10627

Myasthenia gravis is a neuro–muscular disorder characterized by marked weakness and fatigue of muscles affecting the motor apparatus at the Myoneural junction. The management of this disease in ENT practice has been outlined briefly below. This disorder involves all age groups and any muscles in the body, but the disease shows special affinity for muscles innervated by bulbar nuclei (face, lips, eyes, tongue and neck). It is because of this affection that patients of this disorder first go to see the Octolaryngologists.

The cause of the myasthenia gravis is not known, but it is said to be a metabolic disorder. Thymus gland abnormalities have been described in some patients. It has also been said that myasthenia gravis is an auto immune disease, since multiple auto antibodies have been found in the sera of patients of this disorder. The women are more often affected than men and the disease appears between 20 and 40 years of age.

About 20 cases of proved myasthenia gravis were being treated at a hospital in Pune since 1970. Out of this, three patients required thymectomy, two patients went into respiratory failure and had to be subjected for tracheotomy and were subsequently put on the respirator. They died ultimately. Fourteen cases were managed on medical therapy e.g. neostigmine, alternate day steroids and supportive therapy.

Three interesting cases which were presented to our department are given below. The patients were diagnosed for oropharyngeal complaints like dysphagia, dyspnoea, dysphonia, hoarseness, diplopia and ptosis, mimicking the presentation of bulbar palsy, cricopharyngeal and nasopharyngeal malignancies, with neurological involvements.

Read more: Management of Myasthenia Gravis in ENT Practice