Multiple Sclerosis




Imaging Gross Pathology Micro Pathology Treatment


A 25-year-old female has had marked weakness and drooping of the eyelids (= PI'OSIS) in the evening for the past four weeks; she does not experience any weakness in the morning following a good night's sleep.

She has also been suffering from double vision DIPLOPIA) at the end of each day.

Ptosis develops on sustained elevation of eyelids; dysphonia develops as patient is asked to narrate complaints at length; weakness of forward flexion of head develops after repetitive resistance to force; patient could not maintain her upper limb in abducted position for more than a minute.

Clear-cut improvement in strength with edrophonium administration. EMG: progressive decrement in voltage during repetitive, low-frequency stimulation of motor nerve. Positive serum titer of antibodies to acetylcholine receptors.

Acetylcholinesterase inhibitors (pyridostigmine); prednisone; thymectomy; plasmapheresis.

An autoimmune disease due to the development of specific antibodies to one or more acetylcholine receptor subunits, reducing the availability of acetylcholine receptors at the neuromuscular junction. Thymoma is present in 20% of cases.

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