Abstract
A 75-year-old man with severe oculobulbar myasthenia gravis (MG) treated with acetylcholine esterase inhibitors (AChEIs) was found to have muscle-specific tyrosine kinase (MuSK) antibodies. Neurophysiological examination displayed extra repetitive discharges after the compound motor action potential (CMAP) at low-frequency stimulation, possibly triggered by AChEI. This indicates an abnormal sensitivity to acetylcholine in patients with MuSK antibodies and may be a useful indicator of the adverse effect of AChEI treatment in these patients.
Publication types
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Case Reports
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Comparative Study
MeSH terms
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Acetylcholine*
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Action Potentials / drug effects
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Aged
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Antibodies / blood*
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Cholinesterase Inhibitors / therapeutic use
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Electric Stimulation / methods
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Electromyography / methods
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Humans
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Male
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Muscle, Skeletal / innervation
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Muscle, Skeletal / physiopathology
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Myasthenia Gravis / drug therapy
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Myasthenia Gravis / immunology*
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Myasthenia Gravis / pathology
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Myasthenia Gravis / physiopathology*
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Neuromuscular Junction / drug effects
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Neuromuscular Junction / physiopathology*
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Receptor Protein-Tyrosine Kinases / immunology*
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Receptors, Cholinergic / immunology*
Substances
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Antibodies
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Cholinesterase Inhibitors
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Receptors, Cholinergic
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MUSK protein, human
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Receptor Protein-Tyrosine Kinases
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Acetylcholine