Skip to main content

Table 2 Extract of possible differential diagnoses of myasthenia gravis and newly occurring and progressive dysphagia respectively

From: SOP myasthenic crisis

Alternative etiology Syndrome / diagnosis Diagnostic
CNS brainstem-pathology: stroke, rhombencephalitis, multiple sclerosis  • medical history
 • additional symptoms correlating with brainstem-syndrome
 • cMRI
 • cerebral-spinal-fluid (CSF)
intoxication  • cholinergic crisis  • medical history
  o organophosphates  • muscarinergic and nicotinergic symptoms
  o AchE-inhibitors
 • improvement by atropine
 • Botulism
 • medical history
 • Botulinum toxin overdose
 • affection of cranial nerves with tonic pupils
disturbance of the neuromuscular transmission  • Lambert-Eaton-Syndrom  • antibodies (anti-VGKC-Ab)
 • congenital Masthenia gravis  • medical history
 • electrophysiology (increment)
myopathy  • endocrinopathy (hyperparathyreodism, hypo/hyperthyreosis, hyperinsulinism, M. Addison)  • laboratory parameters: TSH, T3/4, CK, potassium etc.
 • specific antibodies
 • medical history
 • hypokaliaemia,
 • electrophysiology
 • dermato/polymyositis,
 • toxic/medication (statins, cortisone)
polyneuropathy / polyradiculopathy  • Guillain-Barré-Syndrome  • CSF
 • Miller-Fisher-Syndrome  • antibodies (anti-gangliosid)
 • intoxication
 • medical history
 • critical-illness-polyneuropathy  • loss of reflexes and sensory deficits
 • electrophysiology
motoneuron disease amyotrophic lateral sclerosis  • medical history
 • fasciculations, spastic paresis
 • electrophysiology
 • cMRI