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Journal of Neurology, Neurosurgery, and Psychiatry logoLink to Journal of Neurology, Neurosurgery, and Psychiatry
. 1972 Jun;35(3):311–322. doi: 10.1136/jnnp.35.3.311

Neurogenic muscle atrophy in myasthenia gravis

Betty Brownell 1,2,1, D R Oppenheimer 1,2, J M K Spalding 1,2
PMCID: PMC494071  PMID: 4338443

Abstract

Two cases of severe myasthenia gravis are described, with histological findings. Both cases showed severe neurogenic atrophy of the muscles of the tongue, with fatty pseudohypertrophy and a remarkable proliferation of terminal nerve fibres. Similar, but less severe, changes were present in other bulbar muscles. The findings are in keeping with the view that functional interruption at the neuromuscular junctions results first in failure to transmit the contractile impulse, and at a later stage in denervation atrophy. Terminal proliferation of axons is regarded as an attempt, on the part of motor fibres, to compensate for the breakdown of normal neuromuscular interaction.

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Selected References

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  1. BICKERSTAFF E. R., WOOLF A. L. The intramuscular nerve endings in myasthenia gravis. Brain. 1960 Mar;83:10–23. doi: 10.1093/brain/83.1.10. [DOI] [PubMed] [Google Scholar]
  2. BRODY I. A., ENGEL W. K. DENERVATION OF MUSCLE IN MYASTHENIA GRAVIS. ROPORT OF A PATIENT WITH MYASTHENIA GRAVIS FOR 47 YEARS AND HISTOCHEMICAL SIGNS OF DENERVATION. Arch Neurol. 1964 Oct;11:350–354. doi: 10.1001/archneur.1964.00460220012002. [DOI] [PubMed] [Google Scholar]
  3. Desmedt J. E. Presynaptic mechanisms in myasthenia gravis. Ann N Y Acad Sci. 1966 Jan 26;135(1):209–246. doi: 10.1111/j.1749-6632.1966.tb45474.x. [DOI] [PubMed] [Google Scholar]
  4. ELMQVIST D., HOFMANN W. W., KUGELBERG J., QUASTEL D. M. AN ELECTROPHYSIOLOGICAL INVESTIGATION OF NEUROMUSCULAR TRANSMISSION IN MYASTHENIA GRAVIS. J Physiol. 1964 Nov;174:417–434. doi: 10.1113/jphysiol.1964.sp007495. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. FENICHEL G. M., SHY G. M. MUSCLE BIOPSY EXPERIENCE IN MYASTHENIA GRAVIS. Arch Neurol. 1963 Sep;9:237–243. doi: 10.1001/archneur.1963.00460090043004. [DOI] [PubMed] [Google Scholar]
  6. Fenichel G. M. Muscle lesions in myasthenia gravis. Ann N Y Acad Sci. 1966 Jan 26;135(1):60–67. doi: 10.1111/j.1749-6632.1966.tb45463.x. [DOI] [PubMed] [Google Scholar]
  7. Goldstein G. The thymus and neuromuscular function. A substance in thymus which causes myositis and myasthenic neuromuscular block in guineapigs. Lancet. 1968 Jul 20;2(7560):119–122. doi: 10.1016/s0140-6736(68)90414-5. [DOI] [PubMed] [Google Scholar]
  8. Guth L. "Trophic" influences of nerve on muscle. Physiol Rev. 1968 Oct;48(4):645–687. doi: 10.1152/physrev.1968.48.4.645. [DOI] [PubMed] [Google Scholar]
  9. Kalden J. R., Williamson W. G., Johnston R. J., Irvine W. J. Studies on experimental autoimmune thymitis in guinea-pigs. Clin Exp Immunol. 1969 Oct;5(4):319–340. [PMC free article] [PubMed] [Google Scholar]
  10. MACDERMOT V. The changes in the motor end-plate in myasthenia gravis. Brain. 1960 Mar;83:24–36. doi: 10.1093/brain/83.1.24. [DOI] [PubMed] [Google Scholar]
  11. McComas A. J., Sica R. E., Brown J. C. Myasthenia gravis: evidence for a "central" defect. J Neurol Sci. 1971 May;13(1):107–113. doi: 10.1016/0022-510x(71)90210-3. [DOI] [PubMed] [Google Scholar]
  12. McComas A. J., Sica R. E., Campbell M. J. "Sick" motoneurones. A unifying concept of muscle disease. Lancet. 1971 Feb 13;1(7694):321–326. doi: 10.1016/s0140-6736(71)91045-2. [DOI] [PubMed] [Google Scholar]
  13. OPPENHEIMER D. R., PALMER E., WEDDELL G. Nerve endings in the conjunctiva. J Anat. 1958 Jul;92(3):321–352. [PMC free article] [PubMed] [Google Scholar]
  14. RUSSELL D. S. Histological changes in the striped muscles in myasthenia gravis. J Pathol Bacteriol. 1953 Apr;65(2):279–289. doi: 10.1002/path.1700650202. [DOI] [PubMed] [Google Scholar]
  15. STEIDL R. M., OSWALD A. J., KOTTKE F. J. Myasthenic syndrome with associated neuropathy. Report of a case, including response to curare therapy. Arch Neurol. 1962 Jun;6:451–461. doi: 10.1001/archneur.1962.00450240029004. [DOI] [PubMed] [Google Scholar]
  16. Smith A. C., Spalding J. M., Ardran G., Livingstone G. Laryngectomy in the management of severe dysphagia in non-malignant conditions. Lancet. 1965 Nov 27;2(7422):1094–1096. doi: 10.1016/s0140-6736(65)90063-2. [DOI] [PubMed] [Google Scholar]
  17. WOHLFART G. Collateral regeneration from residual motor nerve fibers in amyotrophic lateral sclerosis. Neurology. 1957 Feb;7(2):124–134. doi: 10.1212/wnl.7.2.124. [DOI] [PubMed] [Google Scholar]
  18. WOHLFART G. Collateral regeneration in partially denervated muscles. Neurology. 1958 Mar;8(3):175–180. doi: 10.1212/wnl.8.3.175. [DOI] [PubMed] [Google Scholar]

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