Eyes and Bowels Bottled Up - Presentation PPT

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Identifier walsh_2016_s3_c4-1
Title Eyes and Bowels Bottled Up - Presentation PPT
Creator Kristopher Kowal, Jonathan Daniel Trobe, MD, Michigan University, Theodore T. Brown
Subject Myasthenia Gravis; Dysautonomia; Intestinal Pseudo-Obstruction
History A 56 year-old man presented with diplopia and ptosis. Actually he was more concerned about severe constipation that had started about the same time. Abdominal x-rays had shown stool loading; laxatives had been ineffective. Our exam showed bilateral ptosis with complete ophthalmoplegia in both eyes. Pupils were normal, as was the rest of the ophthalmic examination. He had mild hypophonia but an otherwise normal neurologic exam, including intact muscle stretch reflexes. Acetylcholine receptor antibody titers were abnormal: binding 6.39 nmol/L (normal < 0.02nmol/L), striational 1:30270 (normal < 1:60), modulating 95% loss of function (normal 0-20%). To investigate his constipation, we performed abdominal CT, which showed dilated loops of small bowel without apparent obstruction. Within days of starting treatment with pyridostigmine (60mg 5x/day), his constipation was relieved, and CT showed resolution of the dilated bowel loops. But his eye signs persisted.
Date 2016-02-28
Language eng
Format application/pdf
Type Text
Relation is Part of NANOS Annual Meeting Frank B. Walsh Sessions; 2016
Collection Neuro-ophthalmology Virtual Education Library: NOVEL http://NOVEL.utah.edu
Publisher Spencer S. Eccles Health Sciences Library, University of Utah
Holding Institution North American Neuro-Ophthalmology Association. NANOS Executive Office 5841 Cedar Lake Road, Suite 204, Minneapolis, MN 55416
ARK ark:/87278/s6tj1j82
Contributor Primary Kristopher Kowal, Jonathan D. Trobe, Theodore T. Brown
Setname ehsl_novel_fbw
ID 179315
Reference URL https://collections.lib.utah.edu/ark:/87278/s6tj1j82
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