caa a22 4500 445356995 CHVBK 20180317142903.0 cr unu---uuuuu 170323e20110801xx s 000 0 eng 10.1007/s10072-011-0594-4 doi (NATIONALLICENCE)springer-10.1007/s10072-011-0594-4 Anatomical variation of the vertebral artery clinically mimicking myasthenia gravis [Elektronische Daten] [Maria Ejma, Magdalena Koszewicz, Ryszard Podemski, Katarzyna Marianska, Slawomir Budrewicz, Tomasz Turek] Cranial nerve palsy, most commonly trigeminal, abducens, or facial, caused by compression of an ectatic or elongated intracranial artery is a well-known phenomenon. Symptoms of brain stem compression by an abnormal artery have rarely been reported (Tomasello et al. Neurosurgery 56(suppl 1):117-124, 2005). The authors present a 59-year-old woman with intermittent ptosis of the right eye, diplopia and swallowing disturbances, enhanced after physical effort, implying myasthenia gravis. Typical diagnostic procedures, e.g. repetitive nerve stimulation tests, acetylcholine receptor antibodies level were within normal limit. Neurogenic changes from the orbicularis oculi muscle were found in EMG. MRI and angio-CT revealed anatomical variation of the vertebral artery (elongated and arcuate route), causing intermittent signs of brain stem lesion. We point out the similarity of the clinical symptoms of myasthenia gravis and vascular brain stem compression by abnormal vertebral artery. The two diseases require completely different therapeutic proceedings. Springer-Verlag, 2011 Vertebral artery nationallicence Anatomical variation nationallicence Myasthenia gravis nationallicence Ejma Maria Department of Neurology, Wrocław Medical University, Wrocław, Poland aut Koszewicz Magdalena Department of Neurology, Wrocław Medical University, Wrocław, Poland aut Podemski Ryszard Department of Neurology, Wrocław Medical University, Wrocław, Poland aut Marianska Katarzyna Department of Neurology, Wrocław Medical University, Wrocław, Poland aut Budrewicz Slawomir Department of Neurology, Wrocław Medical University, Wrocław, Poland aut Turek Tomasz Department of Radiology, Marciniak Hospital in Wroclaw, Wrocław, Poland aut Neurological Sciences Springer Milan 32/4(2011-08-01), 715-717 1590-1874 32:4<715 2011 32 10072 https://doi.org/10.1007/s10072-011-0594-4 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s10072-011-0594-4 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ejma Maria Department of Neurology, Wrocław Medical University, Wrocław, Poland aut NATIONALLICENCE 700 1- Koszewicz Magdalena Department of Neurology, Wrocław Medical University, Wrocław, Poland aut NATIONALLICENCE 700 1- Podemski Ryszard Department of Neurology, Wrocław Medical University, Wrocław, Poland aut NATIONALLICENCE 700 1- Marianska Katarzyna Department of Neurology, Wrocław Medical University, Wrocław, Poland aut NATIONALLICENCE 700 1- Budrewicz Slawomir Department of Neurology, Wrocław Medical University, Wrocław, Poland aut NATIONALLICENCE 700 1- Turek Tomasz Department of Radiology, Marciniak Hospital in Wroclaw, Wrocław, Poland aut NATIONALLICENCE 773 0- Neurological Sciences Springer Milan 32/4(2011-08-01), 715-717 1590-1874 32:4<715 2011 32 10072 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer