New‐Onset Myasthenia Gravis Mimics Spinal Cord Injury After Zenker's Diverticulum Repair

The clinical features were suggestive of acute cervical spinal cord injury, or central cord syndrome, raising the concern that this devastating complication had resulted from prolonged neck extension during surgery. After additional clinical and laboratory testing, the postoperative diagnosis of new...

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Published inOTO open : the official open access journal of the American Academy of Otolaryngology--Head and Neck Surgery Foundation Vol. 7; no. 2; pp. e56 - n/a
Main Authors Meiler, Steffen E., Siwemuke, Tylin J., Postma, Gregory N.
Format Journal Article
LanguageEnglish
Published United States John Wiley & Sons, Inc 01.04.2023
John Wiley and Sons Inc
Wiley
Subjects
Anesthesia
Case Report
Case Reports
central cord syndrome
drug interactions with myasthenia gravis
Extubation
icepack test
Myasthenia gravis
postoperative myasthenia gravis complications
Postoperative period
Spinal cord injuries
myasthenia gravis
postoperative myasthenia gravis complications
central cord syndrome
icepack test
drug interactions with myasthenia gravis
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Summary:The clinical features were suggestive of acute cervical spinal cord injury, or central cord syndrome, raising the concern that this devastating complication had resulted from prolonged neck extension during surgery. After additional clinical and laboratory testing, the postoperative diagnosis of new-onset MG was confirmed, and the patient received appropriate treatment at our hospital. Of note, the ice pack test used in this patient increases the availability of acetylcholine in the NMJ through cold inhibition of the acetylcholine-degrading enzyme acetylcholinesterase, which explains the high diagnostic performance of this bedside test for MG.
ISSN:2473-974X
2473-974X
DOI:10.1002/oto2.56