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Selective or predominant triceps muscle weakness in African-American patients with myasthenia gravis.
Abraham A1, Kassardjian CD2, Katzberg HD3, Bril V3, Breiner A3.
Neuromuscul Disord. 2017 Apr 21. pii: S0960-8966(17)30013-5. doi: 10.1016/j.nmd.2017.04.009. [Epub ahead of print]
Myasthenia gravis (MG) can lead to weakness in different patterns of muscle groups. Limb muscle weakness is most typically seen in a limb girdle pattern, although variants exist.
In the current study, we aimed to describe a unique MG phenotype consisting of selective or predominant triceps muscle weakness.
We performed a retrospective review of MG patients who developed focal or predominant triceps muscle weakness between 2006 and 2016.
The clinical, electrophysiological and serological characteristics of these patients were examined.
8 MG patients were identified, including 7 males, all of whom were African-American.
Two patients underwent muscle biopsy, and one patient underwent cervical spine decompression surgery.
All showed significant improvement following immunosuppressive treatment, although one patient experienced a relapse of muscle weakness.
This case series highlights a relatively uncommon MG clinical phenotype of selective triceps muscle weakness, mainly in African-American males, in line with previous literature.
Familiarity with this phenotype is important in order to facilitate diagnosis and appropriate treatment for this group, and avoid unnecessary investigations or treatments.