Treatement of dyspnea: the cause of troublesome diagnostic process of neurological illness

Czech version

Authors: MUDr. Michal Scheinost ¹; MUDr. Michaela Martincová ¹; MUDr. Zuzana Podhrázská ¹; MUDr. Andrej Mokeev ¹; MUDr. Martin Forgáč ²
Authors‘ workplace: Interní oddělení Nemocnice Neratovice, Almeda, a. s. ¹; Neurologické centrum Praha Vinoř, s. r. o. ²
Published in: Vnitř Lék 2020; 66(5): 74-75
Category: Case Report

Overview

This casuistic talks about the patient who was admitted to hospital for acute bronchitis. Treatment of respiratory illness led to exacerbation of latent myasthenia gravis (MG). Difficulties in diagnostics of MG were caused by atypical form of illness and also by treatment of bronchitis which modified classical symptoms.

Keywords:

dyspnea – myasthenia gravis – macrolide antibiotics – corticosteroids

Sources

1. Heldal AT, Eide GE, Gilhus NE, Romi F. Geographical distribution of a seropositive myasthenia gravis population. Muscle Nerve 2012; 45 : 815.

2. Oosterhuis HJ. The natural course of myasthenia gravis: a long term follow up study. J Neurol Neurosurg Psychiatry 1989; 52 : 1121.

3. Mantegazza R, Beghi E, Pareyson D, et al. A multicentre follow‑up study of 1152 patients with myasthenia gravis in Italy. J Neurol 1990; 237 : 339.

4. Herishanu Y, Taustein I. The electromyographic changes induced by antibiotics: a preliminary study. Confin Neurol. 1971; 33(1): 41–45. doi: 10.1159/000103101.

5. Cadisch R, Streit E, Hartmann K. Exacerbation of pseudoparalytic myasthenia gravis following azithromycin (Zithromax) [in German]. Schweiz Med Wochenschr.1996; 126(8): 308–310.

6. Schneider‑Gold C, Gajdos P, Toyka KV, Hohlfeld RR. Corticosteroids for myasthenia gravis. Cochrane Database Syst Rev. 2005 Apr 18; (2): CD002828.

7. Pal S, Sanyal D. Jaw muscle weakness: a differential indicator of neuromuscular weakness -⁠ preliminary observations. Muscle Nerve 2011; 43 : 807.