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Pain syndrome, “dropped head” and myasthenia gravis: a case report and literature review
https://doi.org/10.33667/2078-5631-2024-21-7-12
Abstract
The objective of the study is to present a description of the first domestic clinical observation of the painful dropped head syndrome in a patient with myasthenia gravis (MG).
Materials and Methods. Clinical, laboratory and instrumental data were analyzed over the course of MG symptoms with late onset in combination with thymoma, manifesting with pain and weakness in the neck extensors.
Results. The characteristic and unique features of diagnostics and treatment of MG developed in a 59-year-old patient associated with antecollis and significant pain syndrome, initially considered as manifestations of osteochondrosis, are observed in comparison with the literature data. The information on the occurrence, demographic origin, association with the type of receptor targets, thymus pathology and reversibility of these disorders in MG is systematized, and the importance of addressing the concepts of pain in MG is emphasized. The positive effect of ipidacrine in the symptomatic treatment of MG in a patient with marked cholinergic manifestations induced by conventional anticholinergic agents (AA) therapy is confirmed.
Conclusions. MG can cause axial muscle impairment leading to the phenomenon of “dropped head” and the development of pain syndrome atypical for the classical course of the disease. Pathogenetic treatment of seropositive MG in most cases leads to the elimination of its clinical manifestations, including pain. In some cases, the use of the reversible AA ipidacrine is an additional advantage in the therapy of such conditions, taking into account its concomitant proven efficacy as an adjuvant analgesic.
About the Authors
Yu. A. Merkulov
Scientific Research Institute of General Pathology and Pathophysiology
Russian Federation
Russian Federation
Yury A. Merkulov - DM Sci (habil.), chief researcher at the Laboratory of Fundamental and Applied Problems of Pain.
Moscow
E. L. Plieva
B.M. Guekht Neurology center, Central clinical hospital “RZD-Medicine”
Russian Federation
Russian Federation
Elizaveta L. Plieva – neurologist.
Moscow
D. M. Merkulova
B.M. Guekht Neurology center, Central clinical hospital “RZD-Medicine”; I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenovskiy University)
Russian Federation
Russian Federation
Dina M. Merkulova - DM Sci (habil.), head of the Center, B.M. Guekht Neurology center, Central clinical hospital «RZD-Medicine»; professor at Dept of Neurology at the Institute of Professional Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Healthcare of the Russian Federation (Sechenovskiy University).
Moscow
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Review
For citations:
Merkulov Yu.A., Plieva E.L., Merkulova D.M. Pain syndrome, “dropped head” and myasthenia gravis: a case report and literature review. Medical alphabet. 2024;(21):7-12. (In Russ.) https://doi.org/10.33667/2078-5631-2024-21-7-12
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