Reliability and main findings of the flexible endoscopic evaluation of swallowing‐Tensilon test in patients with myasthenia gravis and dysphagia

2018 ◽  
Vol 25 (10) ◽  
pp. 1235-1242 ◽  
Author(s):  
S. Im ◽  
S. Suntrup‐Krueger ◽  
S. Colbow ◽  
S. Sauer ◽  
I. Claus ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Endoscopic Evaluation ◽  
Tensilon Test

scholarly journals Detecting myasthenia gravis as a cause of unclear dysphagia with an endoscopic tensilon test

2021 ◽  
Vol 14 ◽  
pp. 175628642110355
Author(s):  
Tobias Warnecke ◽  
Sun Im ◽  
Bendix Labeit ◽  
Olga Zwolinskaya ◽  
Sonja Suntrup-Krüger ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Sensitivity And Specificity ◽  
Nerve Stimulation ◽  
Serum Antibody ◽  
Significant Heterogeneity ◽  
Swallowing Function ◽  
Repetitive Nerve Stimulation ◽  
Muscle Involvement ◽  
Pharyngeal Dysphagia ◽  
Tensilon Test

Aims: The flexible endoscopic evaluation of swallowing-tensilon test (FTT) was developed to diagnose myasthenia gravis (MG) in patients with unclear pharyngeal dysphagia. The purpose of this study was to determine sensitivity and specificity of the FTT and compare its diagnostic validity with that of other diagnostic markers. Methods: In this single-centre pragmatic clinical cohort study, a total of 100 patients with unclear pharyngeal dysphagia were eligible to undergo FTT. All patients were subjected to FTT and subsequently followed up clinically. FTT was considered positive if a significant improvement of pharyngeal swallowing function could be objectified endoscopically upon administration of edrophonium chloride. In addition, repetitive nerve stimulation test and serum MG antibody analysis were conducted. Results: All subjects (mean age 62.5 ± 14.1 years, female 33) underwent FTT without any complications. According to the results of the diagnostic procedures and based on long-term clinical follow-up for at least 3 years, 51 patients were finally diagnosed with MG. The sensitivity and specificity for the FTT was 88.2% and 95.9%, respectively. Application of the Cochran’s Q test showed statistically significant heterogeneity among the diagnostic tests, with results indicating FTT performance to be more accurate than the repetitive nerve stimulation results ( p < 0.001) and comparable with serum antibody tests ( p > 0.99). Conclusion: FTT has excellent clinical properties to be used routinely in the assessment of dysphagia with isolated or predominant pharyngeal muscle involvement allowing rapid and accurate diagnosis of MG.

Characterization of swallowing disorders in myasthenia gravis through a fibre-optic endoscopic evaluation

2021 ◽  
Vol 84/117 (4) ◽  
Author(s):  
Andrea De Castro ◽  
Rogério Dedivitis ◽  
Debora Queija ◽  
Lica Arakawa-Sugueno ◽  
Mario Castro ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Swallowing Disorders ◽  
Fibre Optic ◽  
Endoscopic Evaluation

Fiberoptic endoscopic evaluation of swallowing with simultaneous tensilon application in diagnosis and therapy of myasthenia gravis

2008 ◽  
Vol 255 (2) ◽  
pp. 224-230 ◽  
Author(s):  
T. Warnecke ◽  
I. Teismann ◽  
J. Zimmermann ◽  
S. Oelenberg ◽  
E. B. Ringelstein ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Endoscopic Evaluation ◽  
Diagnosis And Therapy

Tensilon and the Diagnosis of Myasthenia Gravis: Are We Using the Tensilon Test Too Much?

2001 ◽  
Vol 7 (5) ◽  
pp. 295-299 ◽  
Author(s):  
Michael S. Okun ◽  
Christina M. Charriez ◽  
M. Tariq Bhatti ◽  
Robert T. Watson ◽  
Thomas Swift
Keyword(s):  
Myasthenia Gravis ◽  
Tensilon Test

scholarly journals Specific features of anesthesia in patients with myasthenia gravis

2016 ◽  
Vol 69 (9-10) ◽  
pp. 305-311
Author(s):  
Ivana Spasojevic ◽  
Danica Hajdukovic ◽  
Milena Komarcevic ◽  
Stanislava Petrovic ◽  
Jelena Jovanovic ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Conservative Treatment ◽  
Myasthenia Gravis ◽  
Nicotinic Acetylcholine Receptors ◽  
Acetylcholine Receptors ◽  
Surgical Interventions ◽  
Different Types ◽  
Increased Sensitivity ◽  
Tensilon Test

Introduction. Myasthenia gravis is an autoimmune disease caused by antibodies leading to the destruction of nicotinic acetylcholine receptors on the neuromuscular junction. It is characterized by muscle weakness that gets aggravated with physical activity and improves at rest. Myasthenia Gravis Foundation of America made the clinical classification of Myasthenia gravis which is still in use today. ?Tensilon test? is still the gold standard for the diagnosis of Myasthenia gravis. In addition to this test repeated muscular stimulation can be used as well as the analysis of specific autoantibodies. Treatment of Myasthenia Gravis. In conservative treatment of Mysthenia gravis anticholinesterases, immunosuppressants and plasmapheresis can be used. If conservative treatment does not lead to the desired remission, surgical treatment is indicated. The most accepted indication for thymectomy is the presence of thymoma with generalized form of Myasthenia gravis in adults. How to Distinguish Myasthenic From Cholinergic Crisis. The following is important to make a difference between these two crises: knowledge of the events that preceded the crisis, the size of pupils as well as the presence of muscarinic signs and tensilon test. Specific Features of Anesthesia in Patients with Myasthenia Gravis. Mechanism of the disease development is the reason for the increased sensitivity or resistance of these patients to certain types of drugs used in anesthesia. Protocol of Perioperative Anesthesia in Patients with Myasthenia Gravis. Based on 35 years of experience in the surgical treatment of patients with Myasthenia gravis anesthesiologists at the Department of Thoracic Surgery, Institute for Pulmonary Diseases of Vojvodina, made the protocol of anesthesia and perioperative treatment for these patients. Conclusion. Anesthesiologists may have to deal with a patient with myasthenia gravis in different types of surgical interventions. The protocol for anesthesia and perioperative management of these patients herewith presented may greatly help them in their clinical practice.

scholarly journals Dandy-Walker syndrome in adult mimicking myasthenia gravis

2007 ◽  
Vol 65 (1) ◽  
pp. 173-175 ◽  
Author(s):  
Juliana Cardoso ◽  
Marcos C. Lange ◽  
Paulo J. Lorenzoni ◽  
Rosana H. Scola ◽  
Lineu C. Werneck
Keyword(s):  
Myasthenia Gravis ◽  
Clinical Manifestations ◽  
Clinical Findings ◽  
Repetitive Nerve Stimulation ◽  
Ocular Abnormalities ◽  
Ocular Movements ◽  
Pathologic Features ◽  
Brain Magnetic Resonance Image ◽  
Tensilon Test ◽  
The Brain

The Dandy-Walker syndrome (DWS) is a rare posterior fossa malformation. The DWS can occur associated with other brain or systemic malformations, but ocular abnormalities in this disease are rare and clinical findings mimicking myasthenia gravis have not been described to date. We report a 23-year-old woman who presented mild limitation of the ocular movements with progressive palpebral ptosis, which changed in intensity during the day. The investigation showed negative anti-acetylcholine receptor antibody, repetitive nerve stimulation and "Tensilon test", but the brain magnetic resonance image reveals DWS with hydrocephalus associated with calosal dysgenesis. The characteristic of disease, clinical manifestations and pathologic features, specially the clinical evaluation of ocular abnormalities in suspicion of DWS, including the MG in differential diagnosis are discussed.

scholarly journals Shaker Exercise in Dysphagia Rehabilitation for Myasthenia Gravis Patients

1970 ◽  
Vol 3 (01) ◽  
pp. 1-6
Author(s):  
Andreas Wardono Santoso ◽  
Vitriana
Keyword(s):  
Myasthenia Gravis ◽  
Assessment Tool ◽  
Holding Time ◽  
Endoscopic Evaluation ◽  
Post Intervention ◽  
Aspiration Risk ◽  
Post Test ◽  
Shaker Exercise ◽  
Dysphagia Rehabilitation ◽  
Class Iib

Objective: To evaluate whether Shaker Exercise can improve dysphagia in MG patients.Methods: Pre-Post test design. Ten patients with a confirmed diagnosis of MG (Osserman class IIB) were recruited for this study. All patients did Shaker exercise an hour after taking their medication,with holding time and repetition which increased gradually for 6 weeks. Examinations using Fiber Optic Endoscopic Evaluation of Swallowing (FEES) and Eating Assessment Tool (EAT-10) wereconducted in between.Results: All patients completed 6 weeks of exercise with increased holding time (pre 14±6.11; post 27.5±4.25) and repetition (pre 12.7±6.9; post 20.7±7.75). Only one patient experienced discomfortin their neck muscles. Pre intervention FEES Examination showed that all ten patients have residue (100%), two have spillage (20%), three have penetration risk (30%) and two have aspiration risk(20%). Post intervention showed no residue in seven patients, while three showed decreased residue (70%; 30%; 100%). There was no spillage, penetration risk or aspiration risk in all patients. Pre(11.1±9.386) and post (2.2±2.573) intervention EAT-10 scores show significant improvement (p=0.002).Conclusion: Shaker Exercise can be used safely to improve dysphagia in Myasthenia Gravis patients.Keywords: Myasthenia Gravis, Shaker Exercise, Dysphagia

scholarly journals Ice-on-Eyes Test in the Diagnosis of Myasthenia Gravis

2012 ◽  
Vol 2 (2) ◽  
pp. 92-93
Author(s):  
Nazmul Haque ◽  
Rukhsana Parvin ◽  
Naser Ahmed ◽  
AKM Rafique Uddin
Keyword(s):  
Case Report ◽  
Cost Effectiveness ◽  
Myasthenia Gravis ◽  
Neuromuscular Transmission ◽  
Muscle Membrane ◽  
College Hospital ◽  
Medical College ◽  
Ocular Myasthenia ◽  
Ocular Myasthenia Gravis ◽  
Tensilon Test

Myasthenia gravis is the most frequent autoimmune neuromuscular transmission disorder  with incidence of 2-20 patients per million. Its pathophysiology is autoimmune, with  acetylcholine receptor auto antibodies damaging the post-synaptic fold at the muscle  membrane. The diagnostic confirmation of myasthenia gravis is often challenging. Ice-oneyes  test can be used to diagnose this disease for its simplicity, safety and cost-effectiveness. Here we report a case of myasthenia gravis in Enam Medical College Hospital, Savar, Dhaka where ice-on-eyes test was done with improvement of ptosis of the patient. Aim of this case  report is to make aware our physicians to apply this simple bed side test instead of common  traditional edrophonium (tensilon test) test for confirmation of the diagnosis of ocular myasthenia gravis. DOI: http://dx.doi.org/10.3329/jemc.v2i2.12845 J Enam Med Col 2012; 2(2): 92-93  

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