PDF(Pubmed)
Abstract：
BACKGROUND: Patients with elderly-onset myasthenia gravis can have a good prognosis with appropriate diagnosis and response, although it is difficult to differentiate between exacerbations of myasthenia gravis in elderly patients and age-related changes. Therefore, it is important for physicians to understand the clinical characteristics and safe assessment methods for patients with elderly-onset myasthenia gravis.
METHODS: An 82-year-old male diagnosed with myasthenia gravis 6 months prior had no difficulty in daily living. After falling on a golf course, he was diagnosed with a right femoral neck fracture on the 1st day and underwent right total hip replacement surgery on the 12th day, being transferred to our hospital for rehabilitation therapy on the 32nd day. However, immediately after transfer, the patient showed fatigability during training and difficulty swallowing food.
METHODS: This case was diagnosed as an exacerbation of myasthenia gravis.
METHODS: Pyridostigmine was initiated with the expectation of immediate effect on the 54th day.
RESULTS: His symptoms and physical functions improved immediately, and walking distance and food intake increased. From this clinical course, it was judged that immunosuppressive therapy was indicated as a transition to generalized myasthenia gravis. For this reason, he was discharged after arranging postdischarge visits to the department of neurology, accordingly.
CONCLUSIONS: A better understanding of the characteristics of elderly-onset myasthenia gravis may allow for relatively safe assessment of the condition and improve its diagnosis and treatment.
METHODS: An 82-year-old male diagnosed with myasthenia gravis 6 months prior had no difficulty in daily living. After falling on a golf course, he was diagnosed with a right femoral neck fracture on the 1st day and underwent right total hip replacement surgery on the 12th day, being transferred to our hospital for rehabilitation therapy on the 32nd day. However, immediately after transfer, the patient showed fatigability during training and difficulty swallowing food.
METHODS: This case was diagnosed as an exacerbation of myasthenia gravis.
METHODS: Pyridostigmine was initiated with the expectation of immediate effect on the 54th day.
RESULTS: His symptoms and physical functions improved immediately, and walking distance and food intake increased. From this clinical course, it was judged that immunosuppressive therapy was indicated as a transition to generalized myasthenia gravis. For this reason, he was discharged after arranging postdischarge visits to the department of neurology, accordingly.
CONCLUSIONS: A better understanding of the characteristics of elderly-onset myasthenia gravis may allow for relatively safe assessment of the condition and improve its diagnosis and treatment.
摘要：
背景：老年重症肌无力患者在适当的诊断和反应下可以有良好的预后，尽管很难区分老年患者重症肌无力的加重和年龄相关的变化。因此,了解老年重症肌无力患者的临床特点和安全性评估方法对医师有重要意义。
方法：一名82岁男性，6个月前诊断为重症肌无力，日常生活没有困难。在高尔夫球场上摔倒后，第1天被诊断为右侧股骨颈骨折，第12天接受了右侧全髋关节置换手术，在第32天被转移到我们医院接受康复治疗。然而,转移后立即，患者在训练期间表现出疲劳和吞食困难。
方法：本病例诊断为重症肌无力加重。
方法：开始吡唑斯的明，预期在第54天立即生效。
结果：他的症状和身体功能立即得到改善，步行距离和食物摄入量增加。从这个临床过程中，据判断,免疫抑制治疗被认为是向广泛性重症肌无力的过渡.出于这个原因,他在安排神经科出院后就诊后出院，因此。
结论：更好地了解老年重症肌无力的特点可以相对安全地评估病情并改善其诊断和治疗。
方法：一名82岁男性，6个月前诊断为重症肌无力，日常生活没有困难。在高尔夫球场上摔倒后，第1天被诊断为右侧股骨颈骨折，第12天接受了右侧全髋关节置换手术，在第32天被转移到我们医院接受康复治疗。然而,转移后立即，患者在训练期间表现出疲劳和吞食困难。
方法：本病例诊断为重症肌无力加重。
方法：开始吡唑斯的明，预期在第54天立即生效。
结果：他的症状和身体功能立即得到改善，步行距离和食物摄入量增加。从这个临床过程中，据判断,免疫抑制治疗被认为是向广泛性重症肌无力的过渡.出于这个原因,他在安排神经科出院后就诊后出院，因此。
结论：更好地了解老年重症肌无力的特点可以相对安全地评估病情并改善其诊断和治疗。
