TY - T1的临床推理:双边下垂,吞咽困难,进步的弱点在一位病人的法裔加拿大背景JF -神经学乔-神经病学SP - 933 LP - 938 - 10.1212 / WNL。首页0000000000010613六世- 95 - 20盟Pritikanta保罗AU -雷姆Alhammad盟Elie Naddaf Y1 - 2020/11/17 UR - //www.ez-admanager.com/content/9首页5/20/933.abstract N2 -一个40岁的男人面对慢慢进步的软弱和眼睑droopiness。他30出头开始出现症状,增加疲劳与发挥。30年代中期,他开发了下垂的眼睑无复视。大约3年前,他开始进行性吞咽困难,最初与固体和液体与固体食物,但后来的一致性。他还报道了食物卡在喉咙。他被治疗吸入性肺炎。一年之后,他注意到慢慢进步的把手和近端肢体无力影响下肢,描述为困难拿着平板电脑在教堂,经常把对象从他的手,在从一个坐着的位置站起来和困难。最近,他开始在用力时出现呼吸困难和轻度端坐呼吸。他偶尔有经验的视物模糊没有复视,轻微的落差,嘶哑的声音,主要是对一天结束的时候或者当他累了。 He was diagnosed with seronegative myasthenia gravis at a local facility, with negative acetylcholine receptor, muscle-specific kinase, and low-density lipoprotein receptor-related protein 4 antibodies. His medical and social history were otherwise unremarkable. The patient's father was French Canadian. The patient also had Native American and African American ancestry. There was no family history of myopathy or any neuromuscular disorder. Neurologic examination was significant for moderate bilateral ptosis, bilateral ophthalmoparesis with limited upward gaze and to a lesser extent horizontal gaze (both eye abduction and adduction), mild weakness of both upper and lower facial muscles, moderate weakness of the proximal lower extremities most prominent at the hip abductors (Medical Research Council [MRC] grade 3 to 4-/5), and mild (MRC grade 4) weakness of finger extensors and intrinsic hand muscles. He had no demonstrable fatigable weakness on examination in any of the affected muscles. He had a mildly waddling gait and absent ankle jerks bilaterally. Sensory and coordination evaluations were unremarkable. ER -