88 research outputs found
Encephalopathy associated with autoimmune thyroid disease in patients with Graves' disease: clinical manifestations, follow-up, and outcomes
<p>Abstract</p> <p>Background</p> <p>The encephalopathy associated with autoimmune thyroid disease (EAATD) is characterized by neurological/psychiatric symptoms, high levels of anti-thyroid antibodies, increased cerebrospinal fluid protein concentration, non-specific electroencephalogram abnormalities, and responsiveness to the corticosteroid treatment in patients with an autoimmune thyroid disease. Almost all EAATD patients are affected by Hashimoto's thyroiditis (HT), although fourteen EAATD patients with Graves' disease (GD) have been also reported.</p> <p>Methods</p> <p>We have recorded and analyzed the clinical, biological, radiological, and electrophysiological findings and the data on the therapeutic management of all GD patients with EAATD reported so far as well as the clinical outcomes in those followed-up in the long term.</p> <p>Results</p> <p>Twelve of the fourteen patients with EAATD and GD were women. The majority of GD patients with EAATD presented with mild hyperthyroidism at EAATD onset or shortly before it. Active anti-thyroid autoimmunity was detected in all cases. Most of the patients dramatically responded to corticosteroids. The long term clinical outcome was benign but EAATD can relapse, especially at the time of corticosteroid dose tapering or withdrawal. GD and HT patients with EAATD present with a similar clinical, biological, radiological, and electrophysiological picture and require an unaffected EAATD management.</p> <p>Conclusions</p> <p>GD and HT equally represent the possible background condition for the development of EAATD, which should be considered in the differential diagnosis of all patients with encephalopathy of unknown origin and an autoimmune thyroid disease, regardless of the nature of the underlying autoimmune thyroid disease.</p
Ocrelizumab versus Interferon Beta-1a in Relapsing Multiple Sclerosis
Supported by F. HoffmannâLa Roche
Vestibular evoked myogenic potentials in evaluating brainstem lesions in multiple sclerosis
32nd Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis (ECTRIMS) -- SEP 14-17, 2016 -- London, ENGLANDWOS: 000383267201306European Comm Treatment & Res Multiple Sclerosi
Late onset multiple sclerosis: clinical features and misdiagnosis
29th Congress of the European-Committee-for-Treatment-and-Research-in-Multiple-Sclerosis / 18th Annual Conference of Rehabilitation in MS -- OCT 02-05, 2013 -- Copenhagen, DENMARKWOS: 000328751401009European Comm Treatment & Res Multiple Sclerosi
Clinical and electrophysiological evaluation of dysphagia in myasthenia gravis
OBJECTIVEâTo evaluate dysphagia at the
oropharyngeal stage of swallowing and to determine the
pathophysiological mechanisms of dysphagia in patients with myasthenia gravis.âšMETHODSâFifteen patients with myasthenia gravis
with dysphagia and 10 patients without dysphagia were investigated by a
combined electrophysiological and mechanical method described
previously. Laryngeal movements were detected by a piezoelectric
transducer and the related submental EMG (SM-EMG) and sometimes the EMG
of cricopharyngeal muscle of the upper esophageal sphincter (CP-EMG)
were recorded during dry or wet swallowing. The results of these
electrophysiological variables were compared with those of normal age
matched control subjects.âšRESULTSâIn patients with myasthenia gravis with
dysphagia, it was found that the time necessary for the larynx to
remain in its superior position during swallowing and swallowing
variability in successive swallows increased significantly compared
with normal subjects and with patients with myasthenia gravis without
dysphagia. The total duration of SM-EMG activity was also prolonged in
both groups but more severely in the dysphagic patients.
Electromyographic activity of the CP sphincter was found to be normal
in the dysphagic patients investigated. All the patients with
myasthenia gravis with dysphagia had pathological dysphagia limits
(<20 ml water) whereas other patients except two, were within normal limits.âšCONCLUSIONSâBecause the electrophysiological
variables related to oropharyngeal swallowing were prolonged even in
patients with myasthenia gravis without dysphagia, it is concluded that
the submental and laryngeal elevators are involved subclinically in
myasthenia gravis and, because of compensating mechanisms, the patient
may not be dysphagic. As the CP-EMG behaviour was found to be normal, a
coordination disorder between normal CP sphincter muscle and the
affected striated muscles of the laryngeal elevators may be one of the
reasons for dysphagia in myasthenia gravis. This method also made it
possible to investigate the myasthenic involvement in the laryngeal
elevators that cannot be evaluated by other electrophysiological
methods in myasthenia gravis.âš
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