[Ocular myasthenia gravis].

The article describes an urgent medical and social problem - the diagnosis and treatment of the ocular myasthenia gravis. Despite recent advances in the study of synaptic pathology, the diagnosis of the ocular form of myasthenia gravis remains a challenging problem. This is due to the poor information content of laboratory and electromyographic methods in the diagnosis of ocular myasthenia gravis, and the generalized myasthenia gravis manifests in 90% of cases by external ophthalmoplegia and ptosis.

[Seronegative nonparaneoplastic Lambert-Eaton myasthenic syndrome].

The authors studied two patients with Lambert-Eaton myasthenic syndrome (LEMS) in whom the repeated examination did not find specific of LEMS P/Q type voltage-gates calcium channel autoantibodies. The results of clinical testing and electrophysiological examination showed the typical character of movement disorders with the absence of tendon reflexes and signs of disautonomia as well as a decrease in M-response amplitude and phenomena of decrement with low frequency- and increment with high frequency stimulation. Both patients revealed no signs of paraneoplastic process.

[A comparative analysis of the informative value of anti-AChR-antibody radioimmunoassay and laser correlation spectroscopy in myasthenia gravis].

Aim: An aim of the study was to compare informative value of traditional approach (anti-AChR antibody radioimmunoassay) and evaluation of metabolic shifts by laser correlation spectroscopy in myasthenia gravis.

Material And Methods: The search for the relationship between the disease severity in 77 patients, 12-80 years and the distribution pattern of subfraction serum components revealed three informative zones: 6-15, 27-67, and 127-223 nm.

Results And Conclusion: In patients without disturbances of vital functions, the contribution of the first zone particles into light scatter increases and that of the third zone particles decreases.

[Thoracoscopic thymectomy in children by myasthenia gravis].

The authors' experience of surgical treatment of myasthenia gravis in children was analyzed. 32 patients were operated on, mean age was 13±3 (5-21 years); girls were 26, boys were 6 (19%). Disease severity was IIB-IVB by the MGFA classification, all patients were on anticholinesterase and pednisolone therapy.

[Thymectomy and antibodies to acetylcholine receptors (AChR) in patients with myasthenia gravis in the early postoperative period].

Thymectomy and removal of the hyperplastic thymus have been performed in 21 patients with myasthenia. In 14 patients, thymectomy is performed through thoracoscopic access (TA), while in 7 cases through thoracotomic access (TT). The serum levels of antibodies to acetylcholine receptors (AChR) determined before and after surgery were increased in both groups of patients.

[The use of the QMGS for quantitative assessment of the severity of movement disorders in patients with myasthenia].

The MRC scale is traditionally used for assessment of the severity of movement disorders. The patients' effort is graded on a scale of 0-5. The use of this scale is limited by subjective biases and inadequate assessment of some functions.

[Clinical features of myasthenia related with autoantibodies to muscle specific tyrosine kinase (MuSK)].

Anti-acetylcholine receptor antibodies are detected in 80 to 90% of patients with generalized myasthenia gravis - seropositive myasthenia gravis (SPMG). Approximately 10% to 20% of patients with autoimmune MG do not have antibodies to acetylcholine receptor (AChR) - seronegative MG (SNMG). An immunological study of the blood serum of patients with SNMG revealed patients with or without antibodies to muscle specific tyrosine kinase (MuSK+ and MuSK-, respectively).

[Anti-acetylcholine receptor antibodies: effect of immunosuppressive drug therapy in patients with myasthenia gravis].

We studied anti-acetylcholine receptor antibodies (ARAb) in 25 patients with myasthenia gravis before and after the immunosuppressive drug (steroid) therapy and in 22 patients before and after thymectomy. The clinical effect after the treatment was correlated with the reduction of ARAb levels by more than 20% in 62% of patients. The ARAb levels did not change, or even increased, in 15% patients despite the improvement of their clinical state.

[Clinical and electrophysiological peculiarities of seronegative myasthenia].

Thirty-seven patients with myasthenia gravis (MG) underwent AChR-Ab analysis, clinical study and neurophysiological examination - repetitive nerve stimulation (RNS). About 16,2% of MG patients who were anti-AChR-negative constituted a so-called seronegative MG group (SNMG). Compared to the AChR-Ab positive patients (SPMG), the SNMG was characterized by the higher female/male ratio (6:1), higher frequency of infantile onset of MG (33,3%), absence of association with thymoma and highest frequency of myasthenic crisis (83,3%).

[Myasthenic myopathy].

We have tested clinical and electrophysiological parameters as well as sera for specific anti-titin-antibodies in 40 myasthenic patients with thymoma, 10 with late-onset and 40 with early-onset without thymoma. We have revealed the prevalence of clinical symptoms: chew and bulbar disturbances, neck and deltoideus muscle weakness in the patients with thymoma and late-onset myasthenia gravis without thymoma. These clinical peculiarities were associated with the absence of changes in duration of minimal motor unit potential after correction for synaptic lesions by proserine injections and increase of titin-antibodies level.

[Long-term results of surgical treatment of thymomas at the patients with generalized myasthenia].

Results of diagnosis and treatment of 150 patients with thymoma and generalized myasthenia are analyzed. The results of examination were registered before surgery, and also in 1, 3, 5 and 10 years after one. It is demonstrated that thymoma is potentially malignant tumor with risk of recurrence and requires long follow-up of patient after operation.

[Anti-Titin-antibodies at the patients with myasthenic and non-myasthenic thymoma].

Serum specimens from 52 myasthenic patients with thymoma of various histological characteristics and 4 patients with thymoma without myasthenia have tested for anti-Titin-antibodies titer. It has been demonstrated that organ-specific thymoma dominated at myasthenic patients, and organ-nonspecific thymoma - at the patients without myasthenia. There was no correlation between severe clinical symptoms and the level of anti-Titin-antibodies.

[The differential diagnostic criteria and clinical features of endocrine ophtalmopathy in patients suffering from myastenia with oculomotor disturbances].

The article covers clinical and ophthalmologic characteristics of oculomotor disturbances in myastenic patients with endocrine ophtalmopathy, and differential diagnostic signs and peculiarities of endocrine ophtalmopathy in patients with a combination of the two diseases.

[Lambert-Eatone myastenic syndrome].

A detailed comparative analysis of neurologic symptoms in 45 patients with Lambert-Eatone myastenic syndrome (LEMS) and 42 patients with generalized myasthenia allowed us to single out clinical patterns facilitating disease diagnosis and differentiation. There were no clinical differences in patients having LEMS with or without paraneoplastic process. Electromyography study revealed the presence of typical phenomena: a reduced amplitude of compound muscle action potential and incremental response at 40-Hz stimulation.