Ann Clin Neurophysiol.  2019 Jul;21(2):113-116. 10.14253/acn.2019.21.2.113.

Uncommon coexistence of myasthenia gravis and amyotrophic lateral sclerosis

• Cho EB
• Yang TW
• Jeong H
• Yoon C
• Jung S
• Park KJ

• KMID: 2454735
• DOI: http://doi.org/10.14253/acn.2019.21.2.113

Abstract

Myasthenia gravis (MG) and amyotrophic lateral sclerosis (ALS) are distinct disorders. ALS affects motor neurons that control muscle movement, while MG controls communication between neurons and muscles, which occurs at neuromuscular junctions. However, on rare occasions, ALS develops after MG and vice versa. The coexistence of the two diseases represents a diagnostic challenge and requires thoughtful interpretation of clinical features. We present the case of a 53-year-old Korean male who developed ALS after MG, confirmed by clinical and electrophysiological follow-up.

Keyword

Myasthenia gravis; Amyotrophic lateral sclerosis; Overlap

MeSH Terms

Amyotrophic Lateral Sclerosis*
Follow-Up Studies
Humans
Male
Middle Aged
Motor Neurons
Muscles
Myasthenia Gravis*
Neuromuscular Junction
Neurons

Figure

• 

  Fig. 1 Summary of the clinical course, medications, laboratory and electrophysiologic findings during the follow-up. MG, myasthenia gravis; Tx, treatment; 0d, prednisolone; AZT, azathioprine; IVIG, intravenous immunoglobulin; AChR-ab, acetylcholine receptor antibody; RNST, repetitive nerve stimulation test; FVC, forced vital capacity; BiPAP, bilevel positive airway pressure; MIP/MEP, maximal inspiratory pressure/maximal expiratory pressure; EMG, electromyography; C, cervical; T, thoracic; LS, lumbosacral; B, bulbar.

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