Clinical neurology and neurosurgery
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Clin Neurol Neurosurg · Dec 2003
Tacrolimus hydrate (FK506): therapeutic effects and selection of responders in the treatment of myasthenia gravis.
Tacrolimus hydrate (FK506) reduces myasthenic symptoms due to its immunosuppressive properties. We studied the therapeutic effects of FK506 and noted improvement in 7 of 13 myasthenic patients on the clinical muscle test (myasthenia gravis, MG score). Two other patients with relapsing ocular symptoms improved. We also examined patient sensitivity to FK506, but could not predict such sensitivity before FK506 treatment in the present study.
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Clin Neurol Neurosurg · Dec 2003
Case ReportsYawning despite trismus in a patient with locked-in syndrome caused by a thrombosed megadolichobasilar artery.
We report a 62-year-old woman with a locked-in syndrome with bilateral masticatory spasms and persistent trismus, who was still able to yawn. A vascular malformation of the basilar artery-megadolichobasilar artery (fusiform aneurysm, vertebrobasilar dolichoectasia) was determined to be the underlying cause of this rare combination of symptoms. A thrombus in the megadolichobasilaris as well as an almost total pontine infarction were demonstrated on CT- and MRI-scans. Thus, trismus may be associated with locked-in syndrome due to megadolichobasilar artery thrombus, although yawning is still possible.