上睑下垂
重症肌无力
医学
帕金森病
吡啶斯替明
重复性神经刺激
卡比多巴
发病机制
睑裂
共核细胞病
神经学
内科学
疾病
左旋多巴
外科
α-突触核蛋白
精神科
作者
Qihao Zhang,Erhe Xu,Haifeng Li,Piu Chan,Zhenzhen Zhao,Jinghong Ma
标识
DOI:10.3389/fneur.2023.1303434
摘要
Background Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease. Myasthenia gravis (MG) is a rare autoimmune disease caused by antibodies against the neuromuscular junction. PD and comorbid MG are rarely seen. Case presentation Here we report on a patient who was diagnosed with PD and MG. A 74-year-old man had a 4-year history of bradykinesia and was diagnosed with PD. He subsequently developed incomplete palpebral ptosis, apparent dropped head, and shuffling of gait. The results of neostigmine tests were positive. Repetitive nerve stimulation (RNS) showed significant decremental responses at 3 and 5 Hz in the orbicularis oculi. The patient's anti-acetylcholine receptor (anti-AchR) antibody serum level was also elevated. Meanwhile, 9-[ 18 F]fluoropropyl-(+)-dihydrotetrabenazine positron emission tomography–computed tomography ( 18 F-AV133 PET-CT) scan revealed a significant decrease in uptake in the bilateral putamen. After addition of cholinesterase inhibitors, his symptoms of palpebral ptosis and head drop improved greatly and he showed a good response to levodopa. Conclusion Although PD with MG is rare, we still need to notice the possibility that a PD patient may have comorbid MG. The underlying mechanism of PD and comorbid MG remains unknown, but an imbalance between the neurotransmitters dopamine and acetylcholine and the immune system are likely to play significant roles in the pathogenesis. In this article, we present our case and a literature review on the co-occurrence of PD and MG, reviewing their clinical features, and discuss the underlying pathogenic mechanism of this comorbidity.
科研通智能强力驱动
Strongly Powered by AbleSci AI