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  #1  
Old 08-11-2013
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Default mg or ms?

37 year old women c/o recurrent episodes of double vision,drooping of eyelid..occurs without apparent reason,lasts for hours n resolve spontaneously,occasional hoarseness n difficulty swallowing.
what is the most likely diagnosis?

a) multiple sclerosis
b) myasthenia gravis.
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  #2  
Old 08-11-2013
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ok both seem equally probable but i wud say MG
coz of ptosis
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Old 08-11-2013
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MG makes more sense
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  #4  
Old 08-11-2013
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episodes lasts for hours n then resolve spontaneously..sounds more like relapsing remitting course of ms..
shouldn't mg have progressive worsening of symptoms with further use?
drooping does point to mg but history according to me supports the dx of ms.
still confused!!
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Old 08-12-2013
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What's the answer.I am going with MG:sorry:
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Old 08-12-2013
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MG, pretty classic.

for the diagnosis of MS one needs McDonald criteria, which are not met in here.
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Old 08-12-2013
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Quote:
Originally Posted by DocSikorski View Post
MG, pretty classic.

for the diagnosis of MS one needs McDonald criteria, which are not met in here.
MCdonald criteria have low sensitivityand specificty and they are used for confirmation, you can have a clean MRI and lumbar puncture and still diagnose MS if it has classic symptoms,besides they focus more on diagnostic studies (MRI and pattern of dissemination) + frequency of attacks.

This is more MG though, and a really bad one because she is having bulbar symptoms, the double vision is secondary to orbital muscles weakness.
The weird part is that it comes in waves , instead of having the characteristic progressive decline in muscular function.
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Old 08-12-2013
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yea the symptoms onset and remittance had me confused n more hung up on ms as the diagnosis..
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Old 08-12-2013
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Quote:
Originally Posted by drsrb View Post
yea the symptoms onset and remittance had me confused n more hung up on ms as the diagnosis..
Yeah but apart from that the symptoms She is presenting with are not part of MS, at léast not in the beginning so thats why i believe the dx is MG
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