Clinical, electrophysiological and immunological remissions after thymectomy in myasthenia gravis.

Objectives: Approximately 50% of patients treated with thymectomy have a chance for symptom-free life. However, immunological and neurophysiological abnormalities may be detected in patients with clinical remission. Although improvement usually parallels decrease in acetylcholine receptor antibody (AChRAb) levels and jitter values, there is a question what factors influence immunological and electrophysiological remission in a population of myasthenia gravis (MG) patients.

[Subacute sensory neuronopathy with signs of involvement of anterior horn cells in a patient with small cell lung carcinoma (case report)].

A 55 years old woman with small-cell lung carcinoma is described. Ten months after the diagnosis was established, subacute sensory neuronopathy with the signs of involvement of anterior horn cells (confirmed by EMG exam) occurred. Since neurological symptoms appeared at the time when anti-cancer treatment was ceased, the diagnosis of paraneoplastic lesion peripheral nervous system was established.

[A case of progressive multifocal leucoencephalopathy during chronic lymphocytic leukaemia].

We report here a case of PML in the course of untreated chronic lymphocytic leukaemia. The diagnosis of PML was based on the presence of typical histologic findings in the white matter: focal demyelination, abnormal oligodendroglia with basophilic intranuclear inclusions and enlarged bizarre astrocytes. It was confirmed by immunohistochemistry which revealed JC papova-virus antigens in brain tissue and by in-situ hybridization which showed JC virus genomic DNA in oligodendroglial nuclei.

Muscular fatigability in mitochondrial myopathies. An electrophysiological study.

A frequent occurrence of ophthalmoplegia and muscle fatigability in mitochondrial myopathy (MAM) often makes its differential diagnosis from myasthenia rather difficult. Neuromuscular transmission was investigated in 9 patients with MAM, presenting marked fatigability. The aim of the study was to see whether there were any other causes of muscle fatigability in addition to the metabolic factors.

[Neuropathies in small cell lung cancer].

A routine neurological examination, electromyography studies and conductance in sensory and motoric fibres of upper and lower extremity peripheral nerves, was carried out in 65 subjects with small cell lung cancer prior instituting chemotherapy. None of the patients demonstrated metabolic changes nor toxic injury to the neurological system. The results of the neurological examination led to suspicion of neuropathy in 22 (34%) which was later confirmed by the electromyographic studies.

Pseudoselectivity of the neuromuscular block in ocular myasthenia: a SFEMG study.

The patients with pure ocular myasthenia presenting no signs of neuromuscular transmission defect on classical supramaximal repetitive stimulation were studied using SFMG method. Only those patients were selected to the study in whom the diagnosis of the ocular myasthenia was confirmed by the clinical criteria arranged so as to exclude ophthalmoplegia of the other nature. The series comprises 20 patients in whom the results of the supramaximal repetitive stimulation with the recording from the proximal muscles and with the evaluation of posttetanic phenomena were normal.

[Atypical clinical image of myopathy with abnormal mitochondria (MAM) in our cases].

Two peculiar cases of mitochondrial myopathy are presented. In the first case the diagnostic difficulties are discussed stressing especially the differentiation of the myopathy from myasthenia. In the second cases polyneuropathy signs were evident, which is extremely rare in this myopathy.

[Evaluation of remission in childhood myasthenia gravis].

By the electrophysiological methods such as supramaximal stimulation and single-fibre EMG (SF EMG) 13 children with myasthenia were studied. In only one case the results of both tests were normal. These findings confirm the presence of subclinical disturbances of neuromuscular transmission in most cases of myasthenia during remission.

[Hereditary motor-sensory neuropathy. II. Electrophysiological studies].

Electrophysiological parameters (conduction velocity, distal latency, amplitude of evoked response) were analysed in two types of sensorimotor hereditary neuropathy isolated on the ground of the values of motor conduction velocity in the median nerve which was 38 m/sec. Using this criterion the studied material of 53 cases could be divided into two groups. Group I of 34 cases in which the mean conduction velocity in the median nerve was 16.

Do true remissions in myasthenia really exist? An electrophysiological study.

To answer the question whether true remissions in myasthenia gravis occurred, 20 patients were studied with a history of evident, typical myasthenia but in full clinical remission. Two control groups served as a comparison: one of 10 healthy volunteers and the other of 10 patients with generalized, presently active myasthenia. In 17 of the 20 patients in remission single-fibre EMG (SFEMG) abnormalities were found, indicating some subclinical disturbances of neuromuscular transmission (in 3 cases the results were overtly pathological, in 11 cases moderately pathological, and in 3 cases slightly pathological).

[Disorders of neuromuscular transmission in hyperthyroidism].

Using the method of supramaximal electrostimulation 35 hyperthyroid patients with signs of muscle weakness or muscular fatigability were investigated and in over half the cases (53.5%) disturbances of neuromuscular transmission were found using sufficiently sensitive methods of activation. In nearly 70% of the tested muscles stimulated at 10 Hz a fall of the amplitude of successive potentials was observed.