Anti-MuSK myasthenia gravis with prolonged remission.

Myasthenia gravis (MG) with antibodies against muscle-specific tyrosine kinase (MuSK) is a rare disorder of neuromuscular transmission affecting preferentially bulbar, neck and respiratory muscles. We report the case of a 22-year-old man who presented with diplopia on lateral gaze to both sides, facial diplegia, nasal dysarthria and dysphagia. Repetitive nerve stimulation of the trapezius and orbicularis oculi muscles showed amplitude decrements of 19% and 41% respectively supporting the diagnosis of myasthenia gravis.

Age Limits for Deep Brain Stimulation of Subthalamic Nuclei in Parkinson's Disease.

Background: Clinical pre-operative predictive factors of optimal STN-DBS motor outcome in Parkinson's disease (PD) have been previously reported. However, available data involving elderly patients are conflicting.

Objective: To compare early post-operative outcomes in parkinsonian patients younger than 65 years old (group 1) vs patients 65 years old or older (group 2) at the time of surgery.

Recurrent diplopia over a 30-year period: natural history of a Lewis and Sumner syndrome.

We described the case of a patient with recurrent episodes of isolated diplopia over the last 30 years. On her last event, neurological examination revealed not only a right third and sixth cranial nerves involvement, but also a right peripheral facial palsy and a motor weakness on the left ulnar territory. Electrophysiological nerves motor conduction study revealed a conduction block on the left ulnar nerve and a less severe on the right ulnar nerve.