Myasthenia gravis: a review of available treatment approaches.

Patients with autoimmune myasthenia gravis (MG) should be further classified before initiating therapy, as treatment response varies for ocular versus generalised, early onset versus late onset, and acetylcholine receptor antibody positive versus MuSK antibody positive disease. Most patients need immunosuppression in addition to symptomatic therapy. Prednisolone and azathioprine represent first choice drugs, whereas several second choice options are recommended and should be considered.

Neurological effects of deep diving.

Deep diving is defined as diving to depths more than 50 m of seawater (msw), and is mainly used for occupational and military purposes. A deep dive is characterized by the compression phase, the bottom time and the decompression phase. Neurological and neurophysiologic effects are demonstrated in divers during the compression phase and the bottom time.

Chapter 41: the history of neurology in Scandinavia.

Neurology is well developed in Scandinavia (Denmark, Finland, Iceland, Norway, and Sweden) with a large number of clinical departments and specialists. The care for neurological patients is fairly equally organized even if neurology has evolved from different sources, from psychiatry in Denmark and Finland, internal medicine in Sweden and electrotherapy in Norway. Evidence of diagnostic activity and treatment of neurological diseases can be found in Scandinavia for more than 5000 years.

Myasthenia gravis in the elderly: Is it different?

We have defined myasthenia gravis (MG) in the elderly as onset after the age of 50 years. MG is diagnosed more often today than previously. The increase is mainly found in patients over the age of 50 years.

Something in the Blood? A history of the autoimmune hypothesis regarding myasthenia gravis.

From the first descriptions of myasthenia gravis (MG) in the late nineteenth century, speculation about the cause of MG has centered on the possibility of some curare-like factor circulating in the blood. The transfer of transient myasthenic symptoms from a myasthenic mother to her newborn reinforced this speculation. However, it was not until 1960, when William Nastuk and coworkers noted that serum complement correlated with the clinical course in MG, and Arthur Strauss and colleagues described antiskeletal muscle antibodies in the sera of some MG patients, that a paradigm shift occurred from prior exclusive focus on the neuromuscular junction to a broader consideration of the relevance of immunological mechanisms in myasthenia.

Myasthenia gravis patients with ryanodine receptor antibodies have distinctive clinical features.

Myasthenia gravis (MG) is an autoimmune disease caused in 85% of the patients by acetylcholine receptor (AChR) antibodies. Non-AChR muscle antibodies, against titin and ryanodine receptor (RyR) are mainly found in sera of patients with thymoma or late-onset MG. The occurrence of RyR antibodies increases the risk for severe MG and should lead to active immunomodulating treatment already at MG onset.

Post-polio syndrome patients treated with intravenous immunoglobulin: a double-blinded randomized controlled pilot study.

Post-polio syndrome (PPS) is characterized by new muscle weakness, atrophy, fatigue and pain developing several years after the acute polio. Some studies suggest an ongoing inflammation in the spinal cord in these patients. From this perspective, intravenous immunoglobulin (IvIg) could be a therapeutic option.

Myasthenia gravis: disease severity and prognosis.

Objectives: To examine myasthenia gravis (MG) severity and long-term prognosis in seronegative, seropositive, and thymoma MG.

Materials And Methods: Four series of patients were studied retrospectively. Severity and treatment were assessed each year, and muscle antibodies were assayed.

Titin and ryanodine receptor antibodies in myasthenia gravis.

Some myasthenia gravis (MG) patients have antibodies against skeletal muscle antigens in addition to the acetylcholine receptor (AChR). Two major antigens for non-AchR antibodies in MG are the Ca(2+) release channel of the sarcoplasmic reticulum, the ryanodine receptor (RyR) and titin, a gigantic filamentous muscle protein essential for muscle structure, function and development. RyR and titin antibodies are found mainly in thymoma MG patients and in a few late-onset MG patients and correlate with a severe MG disease.

WHO/WFN Survey of neurological services: a worldwide perspective.

According to the findings obtained in the context of a Global Initiative on Neurology and Public Health carried out by the World Health Organization (WHO), there has been a lack of reliable and comparative data on services and other resources for neurological disorders in many parts of the world. In view of these findings and in collaboration with the World Federation of Neurology (WFN), WHO has recently organized an international Survey of Country Resources for Neurological Disorders, which involved 109 countries and covered over 90% of the world's population. This large WHO/WFN collaborative endeavour collected expert information on a number of aspects of neurological care provision around the world including availability of neurological services in primary care; human resources for neurological disorders; sub-specialized neurological services; primary method of financing of neurological care; and disability benefits for patients with neurological disorders.

The clinical significance of spinal cord injuries in patients older than 60 years of age.

Objectives: To study the causes and the rehabilitation outcome of traumatic spinal cord injury (SCI) in patients older than 60 years at the time of injury.

Material: Forty-four patients were included.

Methods: The American Spinal Injury Association Motor Impairment Scale on admission and at discharge and the Functional Independence Measure Motor subscale at discharge were calculated retrospectively according to the patient records.

Seronegative myasthenia gravis: disease severity and prognosis.

Around 10-20% of myasthenia gravis (MG) patients do not have acetylcholine receptor (AChR) antibodies (seronegative), of whom some have antibodies to a membrane-linked muscle specific kinase (MuSK). To examine MG severity and long-term prognosis in seronegative MG compared with seropositive MG, and to look specifically at anti-AChR antibody negative and anti-MuSK antibody negative patients. Seventeen consecutive seronegative non-thymomatous MG patients and 34 age and sex matched contemporary seropositive non-thymomatous MG controls were included in a retrospective follow-up study for a total period of 40 years.

Striational antibodies in myasthenia gravis: reactivity and possible clinical significance.

Myasthenia gravis is an autoimmune disease caused, in most cases, by antibodies attaching to the acetylcholine receptor. Some myasthenia gravis patients have antibodies that bind in a cross-striational pattern to skeletal and heart muscle tissue sections (striational antibodies). These antibodies react with epitopes on the muscle proteins titin and ryanodine receptor, are found mainly in sera of patients with thymoma and late-onset myasthenia gravis, and may correlate with myasthenia gravis severity.

Myasthenia gravis: clinical, immunological, and therapeutic advances.

We give an update on clinical, immunological, and therapeutic advances in the field of myasthenia gravis, including a summary of suggested therapeutic recommendations.