At a Glance The key symptom that suggests myasthenia gravis in patients is abnormal, painless, and fluctuating weakness of the proximal musculature. Small muscles, such as the ocular and oropharyngeal musculature, are typically affected first, resulting in diplopia, ptosis, dysphagia, and dysarthria. Another striking characteristic is the diurnal fluctuation of the weakness, typically most pronounced…
At a Glance MS is considered in the presence of clinically objective neurologic deficits and evidence of past events of neurologic symptoms (e.g., in the patient history). The neurologic symptoms themselves are notoriously variable and can come in virtually any form. Typical symptoms include paresthesia, weakness, ataxia, dysarthria, sensory deficits, and impaired or double vision.…
At a Glance Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune syndrome associated with malignancies, such as small cell lung-cancer, as well as other diseases, including Sjögren’s syndrome, vitiligo, and thyroid disease. The presenting symptoms are fatigue and muscle weakness, especially of the proximal leg, with weak or absent muscle reflexes. In addition, patients often complain…
At a Glance Amyotrophic lateral sclerosis (ALS) is a neurodegenerative disease characterized neuropathologically by a loss of upper motor neurons in the motor cortex and lower motor neurons in the anterior horn of the spinal cord. Clinically, ALS should be suspected in patients that present with painless focal muscle weakness and atrophy that progresses over…
