anti-musk-positive myasthenia gravis in a patient with parkinsonism and cognitive impairmentanti-musk-positive重症肌无力患者的帕金森症和认知障碍.pdfVIP

Hindawi Publishing Corporation Neurology Research International Volume 2011, Article ID 859802, 4 pages doi:10.1155/2011/859802 Case Report Anti-MuSK-Positive Myasthenia Gravis in a Patient with Parkinsonism and Cognitive Impairment S. Lanfranconi,1, 2 S. Corti,1, 2 P. Baron,1, 2 G. Conti,1, 2 L. Borellini,1, 2 N. Bresolin,1, 2 and A. Bersano1, 2 1 Department of Neurological Sciences, Dino Ferrari Centre, University of Milan, 20122 Milan, Italy 2 IRCCS Foundation Ospedale Maggiore Policlinico Mangiagalli and Regina Elena, Via F. Sforza 35, 20122 Milan, Italy Correspondence should be addressed to A. Bersano, anna.bersano@ Received 22 December 2010; Revised 6 April 2011; Accepted 2 May 2011 Academic Editor: Richard A. Wennberg Copyright © 2011 S. Lanfranconi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Muscle-specific tyrosine kinase- (MuSK-) antibodies-positive Myasthenia Gravis accounts for about one third of Seronegative Myasthenia Gravis and is clinically characterized by early onset of prominent bulbar, neck, shoulder girdle, and respiratory weakness. The response to medical therapy is generally poor. Here we report a case of late-onset MuSK-antibodies-positive Myasthenia Gravis presenting with signs of cognitive impairment and parkinsonism in addition to bulbar involvement and external ophthalmoplegia. The pattern of involvement of both peripheral and central nervous system dysfunction might suggest a common pathogenic mechanism, involving impaired cholinergic transmission. 1. Introduction amplitudes [10]. Here, we