Treatment of myasthenia gravis with dropped head: a report of 2 cases and review of the literature

Neuromuscular Disorders : NMD
Michihiro TamaiTakeshi Nakano

Abstract

We report two patients with myasthenia gravis (MG) who showed dropped head as an early myasthenic manifestation. They had elevated anti-acetylcholine receptor antibody and showed improvement of the symptoms after intravenous injection of edorophonium chloride. One patient had thymoma and developed myasthenic crisis two weeks after thymectomy. The patient recovered from the crisis after a combination of immunoadsorption plasmapheresis (IAPP) and initiation of steroid and tacrolimus. The other patient without thymoma initiated treatment with steroid, tacrolimus and IAPP and showed complete recovery one month later. Dropped head in MG can recover well with immunosuppression therapy using steroid, and IAPP is helpful in getting a rapid improvement of dropped head as well as recovery from myasthenic crisis. When we consider treatment for MG with dropped head, we should take into account that MG of this type can develop myasthenic crisis and use the same treatment strategy as that for generalized MG.

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Citations

Dec 22, 2016·Muscle & Nerve·Marvin SihKourosh Rezania
Apr 18, 2018·Spine·Kazuma MurataKengo Yamamoto
Jan 26, 2017·Practical Neurology·Marija Cauchi, Eleanor Marsh
Sep 17, 2017·The Journal of Emergency Medicine·Jamie RoperAlex Koyfman

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