The diagnosis of ocular myasthenia gravis is rarely in doubt in patients with a proper history and typical clinical findings. However, myasthenia gravis can mimick any pupil- sparing eye movement disorder and several ...The diagnosis of ocular myasthenia gravis is rarely in doubt in patients with a proper history and typical clinical findings. However, myasthenia gravis can mimick any pupil- sparing eye movement disorder and several diseases may masquerade myasthenia g ravis. We review the atypical presentations and differential diagnoses in ocular myasthenia gravis, describing four patients with some of these conditions (4th nerve palsy, near spasm reflex, one-and-a-half syndrome, orbital meningioma). The correct interpretation of the clinical findings associated with appropriate neuro-imaging studies allowed the appropriate diagnosis in these cases.展开更多
纤维肌痛综合征或称纤维组织炎(Fibromyalgia Syndrome or Fibesitis),是指广义的非关节风湿症中的一种肌肉骨髂疼痛症。其临床表现主要有三大症状;肌肉骨骼疼痛、晨僵痛和容易疲乏。因上述症状不具特异性,而常被忽视。美国近十年的研究...纤维肌痛综合征或称纤维组织炎(Fibromyalgia Syndrome or Fibesitis),是指广义的非关节风湿症中的一种肌肉骨髂疼痛症。其临床表现主要有三大症状;肌肉骨骼疼痛、晨僵痛和容易疲乏。因上述症状不具特异性,而常被忽视。美国近十年的研究,尤其是波士顿大学医学中心关节炎组的研究对符合纤维肌病症诊断标准的118例,进行了至少12个月的随访,认为纤维肌痛综合征是一种具有典型病史和体征的疾病。若并发于类风湿性关节炎、强直性脊柱炎、骨性关节炎、干燥综合征等症,称之为继发性纤维肌痛征。本文着重介绍原发性纤维肌痛症。展开更多
Introduction. Hematological diseases are seldom found as the etiology of isch emic strokes, but are frequently investigated by expensive laboratory tests afte r a first cerebral vascular event. Methods. In the Lausann...Introduction. Hematological diseases are seldom found as the etiology of isch emic strokes, but are frequently investigated by expensive laboratory tests afte r a first cerebral vascular event. Methods. In the Lausanne Stroke Registry, we retrospectively reviewed the cases of patients hospitalized between 1979 and 2001 for a first is chemic arterial stroke which was attributed to a hematological etiology. Of 4697 patients, 22 (0.47 per cent) had a stroke due to one of the following hematolog ical pathology: polycythemia vera (4), secondary polycythemia (4), essential thr ombocytemia (2), secondary thrombocytosis (4), multiple myeloma (1), CIVD (1), p rotein S deficiency (1), antiphospholipid antibody syndrome (4), moderate homocy steinemia (1). A literature review was undertaken for each hemopathy. Conclusion . In light of the results of these data, we concluded that a complete blood coun t provides sufficient hematological screening for the majority of patients hospi talized for an arterial stroke. The antiphospholipid antibody syndrome is a rare cause of cerebral infarction, which needs to be investigated in young patients, in cases of multiple or recurring stroke or in the presence of a typical histor y. Inherited thrombophilias are not a significant risk factor for arterial cereb ral infarction and their investigation is only warranted for a sub-group of yo ung patients with a cryptogenic stroke, in which group the prevalence is slightl y increased. Moderate homocysteinemia must be considered as a cerebrovascular ri sk factor of minor importance, but potentially treatable by a substitution of vi tamin B 12, B 6 and folates. The efficacy of this substitution in the prevention of cardiovascular events needs vet to be demonstrated.展开更多
文摘The diagnosis of ocular myasthenia gravis is rarely in doubt in patients with a proper history and typical clinical findings. However, myasthenia gravis can mimick any pupil- sparing eye movement disorder and several diseases may masquerade myasthenia g ravis. We review the atypical presentations and differential diagnoses in ocular myasthenia gravis, describing four patients with some of these conditions (4th nerve palsy, near spasm reflex, one-and-a-half syndrome, orbital meningioma). The correct interpretation of the clinical findings associated with appropriate neuro-imaging studies allowed the appropriate diagnosis in these cases.
文摘纤维肌痛综合征或称纤维组织炎(Fibromyalgia Syndrome or Fibesitis),是指广义的非关节风湿症中的一种肌肉骨髂疼痛症。其临床表现主要有三大症状;肌肉骨骼疼痛、晨僵痛和容易疲乏。因上述症状不具特异性,而常被忽视。美国近十年的研究,尤其是波士顿大学医学中心关节炎组的研究对符合纤维肌病症诊断标准的118例,进行了至少12个月的随访,认为纤维肌痛综合征是一种具有典型病史和体征的疾病。若并发于类风湿性关节炎、强直性脊柱炎、骨性关节炎、干燥综合征等症,称之为继发性纤维肌痛征。本文着重介绍原发性纤维肌痛症。
文摘Introduction. Hematological diseases are seldom found as the etiology of isch emic strokes, but are frequently investigated by expensive laboratory tests afte r a first cerebral vascular event. Methods. In the Lausanne Stroke Registry, we retrospectively reviewed the cases of patients hospitalized between 1979 and 2001 for a first is chemic arterial stroke which was attributed to a hematological etiology. Of 4697 patients, 22 (0.47 per cent) had a stroke due to one of the following hematolog ical pathology: polycythemia vera (4), secondary polycythemia (4), essential thr ombocytemia (2), secondary thrombocytosis (4), multiple myeloma (1), CIVD (1), p rotein S deficiency (1), antiphospholipid antibody syndrome (4), moderate homocy steinemia (1). A literature review was undertaken for each hemopathy. Conclusion . In light of the results of these data, we concluded that a complete blood coun t provides sufficient hematological screening for the majority of patients hospi talized for an arterial stroke. The antiphospholipid antibody syndrome is a rare cause of cerebral infarction, which needs to be investigated in young patients, in cases of multiple or recurring stroke or in the presence of a typical histor y. Inherited thrombophilias are not a significant risk factor for arterial cereb ral infarction and their investigation is only warranted for a sub-group of yo ung patients with a cryptogenic stroke, in which group the prevalence is slightl y increased. Moderate homocysteinemia must be considered as a cerebrovascular ri sk factor of minor importance, but potentially treatable by a substitution of vi tamin B 12, B 6 and folates. The efficacy of this substitution in the prevention of cardiovascular events needs vet to be demonstrated.
