| Part one:A clinical and electrophysiological study of myasthenia gravis ObjectiveIn order to make a comprehensive understanding of myasthenia gravis, the clinical and electrophysiological characteristics of patients with myasthenia gravis were investigated.Materials and MethodsThe clinical and electrophysiological data of 275 in-patients from the Neurology Department of Chinese PLA General Hospital during 1995 to 2010 were collected and analyzed.Results1. The young and middle-aged (198 cases,72.00%) were in the majority of patients with myasthenia gravis compared with children (21 cases,7.64%) and the old (56 cases, 20.36%). Among 131 patients younger than 40, there were 57 men and 74 women, and the male to female ratio was 1:1.3. And the ratio was 1.4:1 (144 cases,84 men and 60 women) for patients over the age of 40. The difference between the two groups was statistically significant (P<0.05). Among the 275 cases, the initial clinical manifestation was extraocular palsy in 149(54.18%) patients, while limbs weakness in 92 patients (33.45%) and bulbar or respiratory muscle weakness in 34 patients (12.37%) respectively.2. RNS test demonstrated a decremental pattern in 216 patients (78.55%). Among all types of MG, the abnormal rate for Type I was the lowest (48.91%), and the differences were statistically significant comparing with other types. The abnormal rate of RNS was the highest when simulation was performed on axillary nerve (58.68%). It was the lowest on ulnar nerve (18.88%), and facial nerve was in between (56.18%). The abnormal rate of RNS was obviously higher when it was recorded on proximal muscles than on distal ones. Needle EMG was performed for 265 patients. Myogenic damage was detected in 89 patients (33.58%), among which spontaneous potentials were found in 11 patients.Conclusions1. MG occurred mainly in the young and middle-aged people. In patients younger than 40, women predominated. After age 40, men were in majority.2. Extraocular palsy was the most common initial symptom. The diagnosis of MG should be taken into consideration for patients with the symptom of fluctuating and asymmetric extraocular muscles weakness.3. RNS was a reliable method for the diagnosis of MG. The abnormal rate of RNS was associated with the clinical classification and regions detected. The abnormal rate of Type I was lower comparing with the other types. And the abnormal rate of RNS was obviously higher when recorded on proximal muscles than on distal ones.4. Needle EMG might demonstrate myogenic damage for patients with MG, and spontaneous potentials might be found in some of them.Part two:Detection of Epstein-Barr Virus in the Thymus of Patients with MGObjectiveTo investigate the relationship between MG and EB virus infection.Materials and MethodsTwo techniques, immunohistochemistry and in situ hybridization, were used to detect EB virus in 30 hyperplastic MG thymuses and 6 control thymuses.ResultsNone of the thymuses showed evidence of EB virus infection by the two methods utilized. ConclusionsOur study indicated that there was no direct connection between EB virus infection and MG with thmic hyperplasia. To identify whether EB virus participate in the pathogenesis of MG, more researches are needed.
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