Using Intravenous Inmunoglobulin in an Atypical Case of Lambert Eaton Síndrome.

A 48 year-old hypertensive, smoker patient who started presenting a generalized weakness, pait instability,visual disorders and uncontrolled blood pressure is presented. At physical examination quadriparesis and weakness extraocular muscles were found. A repetitive estimulation test of low frequency was performed among other lab tests that had compatlbility with gravis myasthenia which was treated and improved. After this, an acute worsening of the condition was found and was treated with intravenous inmunoglobulin which produce a signifcant quantitative improvement. Days after this the patient stated to have some other disorders and, Lambert Eaton myasthenic syndrome was suspected. An electromyography test with 30 Hz was performed proving it. In spite of suffering a Lambert Eaton myasthenic syndrome this patient presented an acute state making a crisis which was improved with the use of intravenous inmunoglobulin. This result make us consider the usage of this medication as a therapeutic option in similar cases.</strong

Crisis miasténica asociada a influenza A H1N1. Presentación de un caso

The infection with seasonal influenza is very common, though it is a prevailing cause of respiratory disease; it has been associated with a variety of neurological complications. However, many cases having neurological complications are not described related to `Influenza' A (H1N1) virus. A case of myasthenic crisis associated with `Influenza' A (H1N1) virus was presented. A 24 year-old female patient was admitted in the otolaryngology service at "Abel Santamaria Cuadrado" University Hospital suffering from rhinolalia, dysphagia and four days of fever followed by acute respiratory failure together with quadriparesis. Through several complementary examinations it was possible to diagnose an infection caused by `Influenza' A (H1N1) virus and myasthenia gravis. Antibiotic-therapy (cefotaxime, amikacin and metronidazole), oseltamivir and intacglobin 400mg/Kg during 5 days was the treatment followed, as the patient showed a marked improvement of the respiratory sepsis and motor defect she was then weaned. The patient was transferred to an internal medicine ward to follow a treatment with prednisone and piridostigmine, having a favorable progress.La infección con influenza estacional es extremadamente común y aunque causa predominantemente enfermedad respiratoria, se ha asociado con una amplia variedad de complicaciones neurológicas. Sin embargo, se han descrito pocos casos de complicaciones neurológicas relacionadas con el virus de la influenza A H1N1. Se describe un caso de crisis miasténica asociada a la influenza A H1N1. Se trata de una paciente de 24 años de edad, que ingresa en el servicio de Otorrinolaringología del Hospital General Docente "Abel Santamaría Cuadrado" por presentar rinolalia, disfagia y fiebre de 4 días de evolución, seguida de una insuficiencia respiratoria aguda y cuadriparesia. Se le realizan varios complementarios diagnosticándose una infección por influenza A H1N1 y una miastenia gravis. Se le administran antibióticos (cefotaxima, amikacina y metronidazol), oseltamivir e intacglobín 400 mg/Kg durante 5 días, con marcada mejoría de la sepsis respiratoria y del defecto motor por lo que es extubada. Posteriormente trasladada a una sala de medicina donde se inicia tratamiento con prednisona y piridostigmina, donde evoluciona favorablemente

Crisis miasténica asociada a influenza A H1N1. Presentación de un caso Myasthenic crisis associated with `Influenza' A (H1N1) virus. A case report

La infección con influenza estacional es extremadamente común y aunque causa predominantemente enfermedad respiratoria, se ha asociado con una amplia variedad de complicaciones neurológicas. Sin embargo, se han descrito pocos casos de complicaciones neurológicas relacionadas con el virus de la influenza A H1N1. Se describe un caso de crisis miasténica asociada a la influenza A H1N1. Se trata de una paciente de 24 años de edad, que ingresa en el servicio de Otorrinolaringología del Hospital General Docente "Abel Santamaría Cuadrado" por presentar rinolalia, disfagia y fiebre de 4 días de evolución, seguida de una insuficiencia respiratoria aguda y cuadriparesia. Se le realizan varios complementarios diagnosticándose una infección por influenza A H1N1 y una miastenia gravis. Se le administran antibióticos (cefotaxima, amikacina y metronidazol), oseltamivir e intacglobín 400 mg/Kg durante 5 días, con marcada mejoría de la sepsis respiratoria y del defecto motor por lo que es extubada. Posteriormente trasladada a una sala de medicina donde se inicia tratamiento con prednisona y piridostigmina, donde evoluciona favorablemente.The infection with seasonal influenza is very common, though it is a prevailing cause of respiratory disease; it has been associated with a variety of neurological complications. However, many cases having neurological complications are not described related to `Influenza' A (H1N1) virus. A case of myasthenic crisis associated with `Influenza' A (H1N1) virus was presented. A 24 year-old female patient was admitted in the otolaryngology service at "Abel Santamaria Cuadrado" University Hospital suffering from rhinolalia, dysphagia and four days of fever followed by acute respiratory failure together with quadriparesis. Through several complementary examinations it was possible to diagnose an infection caused by `Influenza' A (H1N1) virus and myasthenia gravis. Antibiotic-therapy (cefotaxime, amikacin and metronidazole), oseltamivir and intacglobin 400mg/Kg during 5 days was the treatment followed, as the patient showed a marked improvement of the respiratory sepsis and motor defect she was then weaned. The patient was transferred to an internal medicine ward to follow a treatment with prednisone and piridostigmine, having a favorable progress

Myasthenic crisis associated with `Influenza' A (H1N1) virus. A case report

La infección con influenza estacional es extremadamente común y aunque causa predominantemente enfermedad respiratoria, se ha asociado con una amplia variedad de complicaciones neurológicas. Sin embargo, se han descrito pocos casos de complicaciones neurológicas relacionadas con el virus de la influenza A H1N1. Se describe un caso de crisis miasténica asociada a la influenza A H1N1. Se trata de una paciente de 24 años de edad, que ingresa en el servicio de Otorrinolaringología del Hospital General Docente "Abel Santamaría Cuadrado" por presentar rinolalia, disfagia y fiebre de 4 días de evolución, seguida de una insuficiencia respiratoria aguda y cuadriparesia. Se le realizan varios complementarios diagnosticándose una infección por influenza A H1N1 y una miastenia gravis. Se le administran antibióticos (cefotaxima, amikacina y metronidazol), oseltamivir e intacglobín 400 mg/Kg durante 5 días, con marcada mejoría de la sepsis respiratoria y del defecto motor por lo que es extubada. Posteriormente trasladada a una sala de medicina donde se inicia tratamiento con prednisona y piridostigmina, donde evoluciona favorablemente.The infection with seasonal influenza is very common, though it is a prevailing cause of respiratory disease; it has been associated with a variety of neurological complications. However, many cases having neurological complications are not described related to `Influenza' A (H1N1) virus. A case of myasthenic crisis associated with `Influenza' A (H1N1) virus was presented. A 24 year-old female patient was admitted in the otolaryngology service at "Abel Santamaria Cuadrado" University Hospital suffering from rhinolalia, dysphagia and four days of fever followed by acute respiratory failure together with quadriparesis. Through several complementary examinations it was possible to diagnose an infection caused by `Influenza' A (H1N1) virus and myasthenia gravis. Antibiotic-therapy (cefotaxime, amikacin and metronidazole), oseltamivir and intacglobin 400mg/Kg during 5 days was the treatment followed, as the patient showed a marked improvement of the respiratory sepsis and motor defect she was then weaned. The patient was transferred to an internal medicine ward to follow a treatment with prednisone and piridostigmine, having a favorable progress