APPROACH TO THE PATIENT WITH SUSPECTED MYASTHENIA GRAVIS OR ALS: A CLINICIAN'S GUIDE

摘要

Myasthenia gravis (MG) and amyotrophic lateral sclerosis (ALS) are neuromuscular disorders that may share certain symptoms but have vastly different pathophysi-ologies, treatments, and outcomes. ALS is a fatal neurodegenerative disease that causes death of motor neurons in the brain, brainstem, and spinal cord, leading to weakness of voluntary muscles including bulbar, respiratory, facial, trunk, and limb muscles. MG is an autoimmune disease of the neuromuscular junction that leads to a similar distribution of weakness with the additional involvement of the extraocular muscles. The hallmark of MG is fatigable muscle weakness, but patients with ALS may also have fatigue, particularly early in the disease course. Despite these similarities, MG and ALS have distinct clinical characteristics that, when recognized, aid the clinician in making the correct diagnosis.