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 |