Clinical Neuroscience

[Familiaris myasthenia]

CSORBA Antal 1

MARCH 23, 1950

Clinical Neuroscience - 1950;3(01)

[The significantly higher prevalence of the pathology among women, menstruation, natural or artificial menopause, the undoubted influence of pregnancy, persistent thymus, etc., demonstrate the aetiological importance of endocrine factors. It is probable that the so-called constitutional factor is nothing more than an as yet unknown disorder of the endocrine system and that it forms the basis of the chemical mediator disorder.]

AFFILIATIONS

  1. Budapesti Pázmány Péter Tudományegyetem Elme- és Idegkórtani Klinika

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Clinical Neuroscience

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Z. I.

[The first psychiatric and neurological journal in Hungary is now launched. The support of the Academy of Sciences and the Medical-Health Trade Union made it possible to make up for the omission made by the pseudo-scientific cultural policy of the reactionary period. It has already happened in the past that Hungarian medicine started to flourish. Developments in the fields of neurophysiology, neurology and psychiatry began in the second half of the last century, during which Hungarian researchers were connected to the leading medical discoveries of the time in the world.]

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[A 44-year-old male patient was hospitalised with paranoid schizophrenia in 1985. Depot neuroleptic treatment was started which successfully prevented further psychotic relapses for the next ten years. His myasthenia gravis started with bulbar signs in 1997 and the symptoms soon became generalized. The diagnosis of myasthenia gravis was confirmed by electromyography, by positive anticholinesterase test and by the detection of anti-acetylcholine receptor antibodies in the serum. Mediastinal CT examination showed enlarged hilar lymph nodes on the left but no thymic pathology was observed. Mediastinoscopy was performed and biopsies were obtained from the affected nodes. Histology revealed sarcoidosis. The patient suffered respiratory crisis following the thoracic intervention (in September 1998). Combined oral corticosteroid (64 mg methylprednisolone/e.o.d.) and azathioprine (150 mg/day) treatment regimen was initiated and complete remission took place in both the myasthenic symptoms and the sarcoidosis. The follow-up CT scans showed no mediastinal pathology (January 2000). During steroid treatment a transient psychotic relapse occured which was successfully managed by supplemental haloperidol medication added to his regular depot neuroleptics. The patient currently takes 150 mg/day azathioprine and receives 40 mg/month flupentixol depot im. His physical and mental status are stable and he has been completely symptome free in the last 24 months. The association of myasthenia gravis and sarcoidosis is very rare. To our best knowledge no case has been reported of a patient suffering from myasthenia gravis, sarcoidosis, and schizophrenia at the same time.]

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[THE USE OF INTRAVENOUS IMMUNGLOBULIN IN THE TREATMENT OF AUTOIMMUNE NEUROMUSCULAR DISEASES]

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