3-2-04. Ultrasonographic evaluation of facial muscles in myathenia gravis

Publication date: June 2017
Source:Clinical Neurophysiology, Volume 128, Issue 6
Author(s): Hiroshi Tsukamoto, Giuseppe Granata, Daniele Coraci, Ilaria Paolasso, Amelia Evoli, Luca Padua
It is known that the differences of clinical features in myasthenia gravis (MG) depends on the types of antibodies, such as anti-acetylcholine receptor (AChR) or anti-muscle-specific receptor tyrosine kinase (MuSK) antibodies. To evaluate facial muscles in patients with MG using ultrasonography (US), we performed US to measure thickness of facial muscles. Fifty patients with MG (39 AchR positive, 7 MuSK positive, and 4 double-senegative), 8 chronic progressive external ophthalmologia (CPEO) and 36 healthy subjects were enrolled prospectively. Furthermore, the differentiations of thicknesses among three subtypes of MG patients were evaluated to notice antibody-specificity.The Esaote Mylab Gold US system with high-frequency linear probe was used. Muscle thickness was bilaterally measured in frontalis, masseter, and both superior and inferior sites in orbicularis oculi and orbicularis oris. CPEO showed the significant thinning of orbicularis oculi and frontalis (P<0.01). MG showed significant thinning of orbicularis oculi, the superior sites of orbicularis oris and masseter (P<0.05). Moreover, the thickness in the inferior sites of orbicularis oris was thinnest in patients with MuSK positive MG (P<0.01) among three subtypes. US is very useful for evaluating pathological specificity of facial muscles in patients with MG and CPEO.



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