Journal of Psychiatry

High Cervical Disc Herniation (C3-C4) with Superimposed Myasthenia Gravis in a 38-year Old Female: A Case Report

Godard Espiritu Artajos and Marissa Ong East Avenue Medical Center, Philippines

Published: 16-Sep-2020

Abstract

Myasthenia gravis and High cervical disc herniation are uncommon diseases and rarely occurs at the same time. Each condition is caused by different etiologies and pathophysiology. We report a case of a 38-year old Filipino female who was admitted due to head drop. She experienced bowel and bladder incontinence and progressive proximal muscle weakness for nine months and eventually developed cranial muscle symptoms like dysphagia, dysphonia and ptosis. She was admitted as a case of cervical spine spondylosis but worsened after physical therapy despite IV steroids. Positive prostigmine test and repetitive nerve stimulation test confirmed presence of concomitant Myasthenia Gravis. In conclusion, we describe here a case of high cervical cord compression with superimposed myasthenia gravis. That the pattern of weakness caused by the spinal cord lesion can hide the classic fatigable pattern of weakness in myasthenia gravis. The presence of cranial muscle involvement and worsening of weakness after physical therapy favors myasthenia gravis. Early diagnosis of concurrent myasthenia and initiation of proper treatment helps in preventing possible complications that can prolong hospitalization in patients with high cervical cord compression.

Biography:

Godard Espiritu Artajos, MD has completed his medical degree at age 26 years from the University of Santo Tomas Faculty of Medicine and Surgery. He is currently a Senior Resident-in-training under the Adult Neurology Program of the East

Avenue Medical Center Department of Neurosciences, a tertiary government hospital in the heart of the Philippines. He aspires to pursue Neurophysiology fellowship abroad and go back to serve the Filipino people.

Speaker Publications:

1 Scoppetta C, Onorati P, Eusebi F, et al. “Autoimmune myasthenia gravis after cardiac surgery”. J Neurol Neurosurg Psychiatry 2003; 74:392-3. 10.1136/jnnp.74.3.392.

2. Pavlov VA, Tracey KJ. “The vagus nerve and the inflammatory reflex-linking immunity and metabolism”. Nat Rev Endocrinol 2012; 8:743-54. 10.1038/nrendo.2012.189.

10th International Conference on Neurological disorders & Stroke; Webinar-August 21-22, 2020.

Abstract Citation:

Godard Espiritu Artajos, High cervical disc herniation (C3-C4) with superimposed myasthenia gravis in a 38-year old female: A case report, Stroke Congress 2020, 10th International Conference on Neurological disorders & Stroke Webinar- August 21-22, 2020.

(https://stroke.neurologyconference.com/abstract/2020/high-cervical-disc-herniation-c3-c4-with-superimposed-myasthenia-gravis-in-a-38-year-old-female-a-case-report)