open access

Vol 51, No 2 (2017)
Case reports
Submitted: 2016-08-03
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Excessive daytime sleepiness in a patient with coexisting myotonic dystrophy type 1, myasthenia gravis and Graves’ disease

Katarzyna Kapica-Topczewska, Robert Pogorzelski, Joanna Tarasiuk, Wiesław Drozdowski, Piotr Lewczuk, Alina Kułakowska
DOI: 10.1016/j.pjnns.2017.01.007
·
Neurol Neurochir Pol 2017;51(2):190-193.

open access

Vol 51, No 2 (2017)
Case reports
Submitted: 2016-08-03

Abstract

A 41-year-old female with history of Graves’ disease, bilateral cataract, paroxysmal atrial fibrillation was admitted because of muscle weakness, daytime sleepiness, fatigability, drowsiness, bilateral eyelid ptosis, descending of head and lower jaw. On neurological examination the patient was presented with muscle weakness, muscle atrophy (in face and sternocleidomastoid muscles), features of myotonia and apocamnosis (orbicular muscles). Electromyography revealed myopathic changes, myotonic and pseudomyotonic discharges, positive repetitive nerve stimulation test in proximal muscles. Myotonic dystrophy (MD) diagnosis was confirmed by genetic testing and myasthenia gravis (MG) by a positive titer of cholinergic receptor autoantibodies. In the CSF concentration of hypocretin was significantly decreased.

Abstract

A 41-year-old female with history of Graves’ disease, bilateral cataract, paroxysmal atrial fibrillation was admitted because of muscle weakness, daytime sleepiness, fatigability, drowsiness, bilateral eyelid ptosis, descending of head and lower jaw. On neurological examination the patient was presented with muscle weakness, muscle atrophy (in face and sternocleidomastoid muscles), features of myotonia and apocamnosis (orbicular muscles). Electromyography revealed myopathic changes, myotonic and pseudomyotonic discharges, positive repetitive nerve stimulation test in proximal muscles. Myotonic dystrophy (MD) diagnosis was confirmed by genetic testing and myasthenia gravis (MG) by a positive titer of cholinergic receptor autoantibodies. In the CSF concentration of hypocretin was significantly decreased.

Get Citation

Keywords

Myotonic dystrophy, Myasthenia gravis, Graves’ disease, Hypocretin

About this article
Title

Excessive daytime sleepiness in a patient with coexisting myotonic dystrophy type 1, myasthenia gravis and Graves’ disease

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 2 (2017)

Pages

190-193

DOI

10.1016/j.pjnns.2017.01.007

Bibliographic record

Neurol Neurochir Pol 2017;51(2):190-193.

Keywords

Myotonic dystrophy
Myasthenia gravis
Graves’ disease
Hypocretin

Authors

Katarzyna Kapica-Topczewska
Robert Pogorzelski
Joanna Tarasiuk
Wiesław Drozdowski
Piotr Lewczuk
Alina Kułakowska

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