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      Dysphagia in myasthenia gravis: the tip of the Iceberg.

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          Abstract

          We evaluated swallowing function in patients with myasthenia gravis (MG) with or without dysphagia symptoms using different evaluation parameters and compared the results with those of healthy subjects. A total of 36 patients with MG and 25 healthy volunteers were included in the study. The subjects were classified into three groups; patients without dysphagia (group 1), patients with dysphagia (group 2), and healthy participants (group 3). The presence and severity of dysphagia, the oropharyngeal, pharyngeal, pharyngoesophageal, and esophageal phases were assessed using a screening test, manometric test, electrophysiologic studies [electroneuromyography (EMG)], fiberoptic endoscopic evaluation of swallowing (FEES), and barium swallow pharyngeal esophagography (BSPE), respectively. There was a significant difference between group 1 and group 3 in terms of BSPE (p = 0.001) and manometry tests (p = 0.001). A significant difference was found in all methods between group 2 and group 3 (p = 0.001, for all). In the comparison of the patient groups, although the number of patients with dysphagia in group 2 was significantly higher in the clinical tests (p = 0.007), FEES (p = 0.001), and EMG (p = 0.043) than in group 1, no difference was detected for BSPE (p = 0.119) and manometry (p = 0.644). Swallowing functions in patients with MG may be affected even without symptoms. This condition should be considered in their follow-up.

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          Author and article information

          Journal
          Acta Neurol Belg
          Acta neurologica Belgica
          Springer Science and Business Media LLC
          2240-2993
          0300-9009
          Jun 2018
          : 118
          : 2
          Affiliations
          [1 ] University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Altindag, Ankara, Turkey. ebruumay@gmail.com.
          [2 ] Ankara Education and Research Hospital, Gastroenterology Clinic, Ankara, Turkey.
          [3 ] University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Physical Medicine and Rehabilitation Clinic, Altindag, Ankara, Turkey.
          [4 ] University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Neurology Clinic, Ankara, Turkey.
          [5 ] University of Health Sciences, Ankara Diskapi Yildirim Beyazit Training and Research Hospital, Otolaryngology-Head & Neck Surgery Clinic, Ankara, Turkey.
          Article
          10.1007/s13760-018-0884-1
          10.1007/s13760-018-0884-1
          29417423
          b216d3f4-f8c0-4a68-b5bb-47f80998cb4f
          History

          Barium swallow pharyngeal esophagography,Electroneuromyography,Myasthenia gravis,Manometry,Dysphagia,Fiberoptic endoscopic evaluation swallowing

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