- |||||||||| levetiracetam / generics
An unusual presentation of status epilepticus. () - Sep 10, 2019 - Abstract #EUSEM2019EUSEM_1280;
At this time outcome for both patients is still unclear- both of them are still ventilated and hospitalized in ICU. One of the lessons learned is that toxicology screening is very helpful, but you need to know what to look for.
- |||||||||| Journal: Research Advances in Ocular Myasthenia Gravis (Pubmed Central) - Sep 7, 2019
The role of early steroid treatment for cardiac involvement should warrant further investigations. Ocular myasthenia gravis(OMG)is an autoimmune disease caused by neuromuscular junction transmission disorders and manifested mainly as fluctuating blepharoptosis and diplopia,with the extraocular muscles as the main involveed sites.While the pathogenesis of OMG remains unclear,some antibodies,complements,and cytokines may be the contributing factors.The diagnosis and treatment of OMG have been defined in recent years.This article reviews the pathogenesis,diagnosis,and treatment of OMG.
- |||||||||| Clinical, Journal, IO Biomarker: Congenital myasthenic syndromes in adult neurology clinic: A long road to diagnosis and therapy. (Pubmed Central) - Sep 6, 2019
Misdiagnosis occurred in 94% of the adult patients with CMS and causes a median diagnostic delay of nearly 3 decades from symptom onset. Seronegative myasthenia gravis and muscle diseases were the 2 most common misdiagnoses, which led to treatment delay and unnecessary exposure to immunotherapy, thymectomy, or muscle biopsy.
- |||||||||| Journal: Thyroid Eye Disease and Myasthenia Gravis. (Pubmed Central) - Sep 6, 2019
Seronegative myasthenia gravis and muscle diseases were the 2 most common misdiagnoses, which led to treatment delay and unnecessary exposure to immunotherapy, thymectomy, or muscle biopsy. No abstract available
- |||||||||| Clinical, Journal: Mindful Breathing Offers Relief for Myasthenia Gravis: A Case Report. (Pubmed Central) - Sep 3, 2019
Additionally, these results may be explained by the cholinergic anti-inflammatory pathway, wherein increased acetylcholine dampens the innate immune response. This report offers the possibility of a simple, non-pharmacological treatment of MG-related ptosis and potentially MG symptoms as a whole, with potential application toward other autoimmune disorders.
- |||||||||| Clinical, Journal: Minimally Invasive Thymectomy and Lung Volume Reduction in a Patient with Myasthenia Gravis. (Pubmed Central) - Aug 30, 2019
We describe the case of a patient with myasthenia gravis and severe pulmonary emphysema who underwent concomitant bilateral video/robotic-assisted thymectomy with unilateral lung volume reduction surgery. We review the important pathophysiological considerations that must be appreciated to ensure safe surgery in this unusual situation with two diseases that independently affect the respiratory system - each of which requires preoperative optimization.
- |||||||||| tacrolimus / Generic Mfg.
Clinical, Journal: Long-Term Safety and Efficacy of Tacrolimus in Myasthenia Gravis. (Pubmed Central) - Aug 30, 2019
Tacrolimus may be effective in reducing the severity of MG and may permit a reduction in the steroid dose prescribed to the patients. Adverse events due to tacrolimus treatment were not serious.
- |||||||||| Review, Journal: Ocular Myasthenia. (Pubmed Central) - Aug 30, 2019
Cogan lid twitch, enhanced ptosis, peek sign, and saccadic fatigue are specific examination findings that support the clinical diagnosis of myasthenia gravis. Confirmation of the diagnosis is challenging with autoantibody serology, and repetitive nerve stimulation studies are often negative.
- |||||||||| Review, Journal: Diagnosis of Myasthenia Gravis. (Pubmed Central) - Aug 30, 2019
The most sensitive test is single-fiber electromyography. In this article, the authors review the diagnostic testing approach of practicing clinicians for suspected MG cases.
- |||||||||| Review, Journal: Nature and Action of Antibodies in Myasthenia Gravis. (Pubmed Central) - Aug 30, 2019
This article discusses antibodies associated with immune-mediated myasthenia gravis and the pathologic action of these antibodies at the neuromuscular junctions of skeletal muscle. To explain how these antibodies act, we consider the physiology of neuromuscular transmission with emphasis on 4 features: the structure of the neuromuscular junction; the roles of postsynaptic acetylcholine receptors and voltage-gated Na channels and in converting the chemical signal from the nerve terminal into a propagated action potential on the muscle fiber that triggers muscle contraction; the safety factor for neuromuscular transmission; and how the safety factor is reduced in different forms of autoimmune myasthenia gravis.
- |||||||||| Soliris (eculizumab) / Alexion Pharma
Review, Journal: Treatment of Myasthenia Gravis. (Pubmed Central) - Aug 30, 2019
Nearly all of the drugs used for MG are considered "off-label." The 2 exceptions are acetylcholinesterase inhibitors and complement inhibition with eculizumab, which was recently approved by the US Food and Drug Administration for myasthenia gravis. This article reviews the evidence base and provides a framework for the treatment of myasthenia gravis, highlighting recent additions to the literature.
- |||||||||| Clinical, Review, Journal: Measuring Clinical Treatment Response in Myasthenia Gravis. (Pubmed Central) - Aug 30, 2019
We discuss instruments that gauge disease overall health impact, such as on disability and quality of life. Finally, we discuss other relevant outcomes such as steroid-sparing effects and the role of surrogate markers.
- |||||||||| Review, Journal: An Update: Myasthenia Gravis and Pregnancy. (Pubmed Central) - Aug 30, 2019
Patients should not be discouraged to become pregnant, but provided with supportive counseling, planning, and monitoring in a multidisciplinary team involving obstetrician, anesthesiologist, pediatrician, and neurologist. Pregnancy outcome is favorable in women who receive treatment and expert care.
- |||||||||| Review, Journal: Congenital Myasthenic Syndromes. (Pubmed Central) - Aug 30, 2019
Many of these syndromes present within the first few years of life with fluctuating and fatiguable weakness in a distribution similar to myasthenia gravis, although a limb-girdle distribution and late onset are also seen in certain specific types of CMS. Electrodiagnostic testing with repetitive nerve stimulation may be helpful in some forms of CMS.
- |||||||||| Review, Journal: Lambert-Eaton Myasthenic Syndrome. (Pubmed Central) - Aug 30, 2019
Diagnosis is confirmed by serologic testing and electrophysiologic studies. 3,4-diaminopyridine is effective symptomatic treatment of LEMS.
- |||||||||| Review, Journal: Management of Myasthenia Gravis in Pregnancy. (Pubmed Central) - Aug 30, 2019
This article provides a description of the disease process and its impact on the expecting mother, fetus, and newborn. Management options in pregnancy and lactation are discussed.
- |||||||||| Review, Journal: Neuro-Ophthalmic Disorders in Pregnancy. (Pubmed Central) - Aug 30, 2019
This article discusses pregnancy-related considerations for meningioma, pituitary disorders, demyelinating disease, myasthenia gravis, thyroid eye disease, idiopathic intracranial hypertension, cerebral venous sinus thrombosis, stroke, migraine, and cranial neuropathies. The article also details the potential neuro-ophthalmic complications of preeclampsia and eclampsia and reviews the use of common diagnostic studies during pregnancy.
- |||||||||| Soliris (eculizumab) / Alexion Pharma, Ultomiris IV (ravulizumab IV) / Alexion Pharma
Therapeutic complement inhibition in neuroinflammatory diseases (Hall F) - Aug 28, 2019 - Abstract #ECTRIMS2019ECTRIMS_1455;
a Phase 3, prospective, randomized, double-blind, placebo-controlled, parallel-group, multi-center, time-to-event trial evaluated the safety and efficacy of Eculizumab for patients with relapsing NMOSD; 3. A long-term safety and efficacy of Eculizumab is being performed in patients with relapsing NMOSD who have completed the initial Phase 3.
- |||||||||| Antibody-mediated pathogenesis in central and peripheral neuroinflammatory disorders (Hall F) - Aug 28, 2019 - Abstract #ECTRIMS2019ECTRIMS_1424;
In this lecture, we will examine how autoantibody isotype and autoantigen presentation combine to determine antibody-mediated pathology in central and peripheral neuroinflammatory disorders. We will then use these principles to review current and future therapeutic strategies.
- |||||||||| Antibody- and complement-mediated effector functions (Hall F) - Aug 28, 2019 - Abstract #ECTRIMS2019ECTRIMS_1413;
The Educational Session will provide both clinicians and MS researchers with an (i) an overview on effector mechanisms of antibodies and complement activation, (ii) illustrate their role in the pathogenesis of central (MS, NMOSD, MOGAS, AE) and peripheral (myasthenia gravis, inflammatory neuropathies) neurologic diseases, and (iii) highlight the therapeutic potential of strategies targeting antibody-mediated immune responses and complement activation. The session requires basic knowledge in immunology.
- |||||||||| Campath (alemtuzumab) / Sanofi, Lemtrada (alemtuzumab) / Sanofi
Myasthenia gravis presenting in pregnancy in a woman treated with Alemtuzumab (Poster Exhibition) - Aug 28, 2019 - Abstract #ECTRIMS2019ECTRIMS_1021;
There is a danger that the symptoms of myasthenia may be mistaken for MS relapse. In this case the relevance of making the diagnosis was particularly important because of the risk of transfer of maternal antibodies and the risk of myasthenia in the newborn.
- |||||||||| Opdivo (nivolumab) / Ono Pharma, BMS
Clinical, Journal: An autopsy case of nivolumab-induced myasthenia gravis and myositis (Pubmed Central) - Aug 22, 2019
Immunohistochemical analysis showed that CD8-positive T cells mainly infiltrates in the endomysium with a small number of CD4-potive T cells. Here, we report an autopsy case of nivolumab-induced myasthenia gravis and myositis.
- |||||||||| Review, Journal: Ectopic thymic tissue and ectopic thymic tumors (Pubmed Central) - Aug 21, 2019
In this context, the following article covers the etiology, prevalence, and location of normal-looking, reactive, and neoplastic ectopic thymic tissue. Furthermore, ectopic tissues and tumors inside or adjacent to the thymus are mentioned.
- |||||||||| Clinical, Journal: EQ-5D-5L and SF-6D Health Utility Index Scores in Patients with Myasthenia Gravis. (Pubmed Central) - Aug 21, 2019
We present estimates of health utilities for patients with Myasthenia Gravis that can be used in cost-utility and decision analyses. Limb/axial symptoms had a higher impact on health utilities than ocular or bulbar symptoms and this might reflect the impact of mobility on health valuation.
- |||||||||| Journal: Optimal management of thymic malignancies: current perspectives. (Pubmed Central) - Aug 16, 2019
In 2010, the French National Institute of Cancer labeled the RYTHMIC network as a specific tumor board including thoracic surgeons, oncologist, and radiation therapist to define standard of care for the management of TETs. The aim of the review was to update knowledge to optimize the standard of care.
- |||||||||| Rituxan (rituximab) / Roche, Biogen
Journal: Autoantibody-producing plasmablasts after B cell depletion identified in muscle-specific kinase myasthenia gravis. (Pubmed Central) - Aug 15, 2019
...However, the duration of this benefit may be limited, as we observed disease relapse in MuSK MG patients who had achieved rituximab-induced remission...The autoantibodies displayed hallmarks of antigen-driven affinity maturation. These collective findings introduce potential mechanisms for understanding both MuSK autoantibody production and disease relapse following B cell depletion.
- |||||||||| Clinical, Journal: Is thymomectomy equivalent to complete thymectomy in non-myasthenic patients with early-stage thymoma? (Pubmed Central) - Aug 15, 2019
Conversely, the studies of the Japanese Association for Research on the Thymus and the Chinese Alliance for Research in Thymoma found a higher rate of local recurrence in the thymomectomy group than in the thymectomy group. The National Comprehensive Cancer Network, National Cancer Institute and International Thymic Malignancy Interest Group recommend complete thymectomy in non-myasthenic patients with early thymoma; therefore, the identified studies in this review are not strong enough to change this recommendation.
- |||||||||| Journal: Modern principles of neurocritical care (Pubmed Central) - Aug 15, 2019
Modern treatment principles in neurocritical care mainly aim at avoiding or attenuating secondary neurological brain damage, in particular directed at sufficient perfusion and oxygenation. These include measures such as neuroprotective ventilation, stabilization of the circulation, decreasing intracranial pressure in brain edema and space-occupying processes, anticonvulsive treatment, temperature management and targeted disease-specific treatment.
- |||||||||| Journal: Congenital myasthenic syndrome caused by novel COL13A1 mutations. (Pubmed Central) - Aug 15, 2019
Response to acetylcholinesterase inhibitor treatment was generally negative while salbutamol proved beneficial. Our data further support the causality of COL13A1 variants for CMS and suggest that this type of CMS might be clinically homogenous and requires alternative pharmacological therapy.
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