Neurological manifestations in malignant melanoma

• Published in: Practical neurology Vol. 24; no. 5; pp. 428 - 431
• Main Authors: Herath, H M M T B, Lutchman, Nadiene G, Saleh, May, Naidu, Leena, Alagoda, Shyama Balasuriya, Brady, Stefen, Wimalaratna, Sunil
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group Ltd 20.02.2024; BMJ Publishing Group LTD
• Subjects: Antibodies; Apheresis; Biopsy; Edema; Electromyography; Enzymes; Guillain-Barre syndrome; Hepatitis; IMMUNOLOGY; Kinases; Melanoma; Meningitis; MUSCLE DISEASE; MYASTHENIA; Myasthenia gravis; Myocarditis; NEUROPATHY; ONCOLOGY; Ostomy; Patients; Skin cancer; Test yourself; MYASTHENIA; NEUROPATHY; IMMUNOLOGY; ONCOLOGY; MUSCLE DISEASE
• ISSN: 1474-7758; 1474-7766; 1474-7766
• DOI: 10.1136/pn-2023-003966

Correspondence to Dr H M M T B Herath, Kettering General Hospital, Kettering, UK; tharukaherath11@gmail.com Case presentation A 72-year-old woman had 1 week of diplopia, bilateral ptosis, dysphagia, myalgia and limb weakness, and 3 days of progressively worsening shortness of breath. MR scans of orbits with contrast found no features of orbital myositis or melanoma metastasis but did show significant bilateral extraocular orbital muscle atrophy (figure 1A,B). The negative results probably result from the co-occurrence myasthenia gravis and myositis.11 12 There is no clear explanation for the consistently observed discrepancy between the electrophysiological tests of conventional myasthenia and the myasthenia caused by immune checkpoint inhibitors. Demography Bimodal distribution with an early peak in the second and third decades (female predominance) and a late peak in the 6th–8th decade (male predominance) Most are elderly men (may be explainable by the target population for these treatments).