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Questions posted in the
Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.
Question Title: Respiratory Problems and MGForum: Neurology Forum
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I am suffering from pain 2" below the sternum area and in the sternum areaa, but mostly my rib cage. I have shortness of breathe due to MG. I was just diagnosed and waiting to find out what med's I will go on. I have a very heavy feeling in my chest and only get these pains when sitting for awhile at the computer. I know I slouching when I get really weak and my head gets heavy. I sometimes force myself to continue at the computer while doing research. That's when the pains start. Can the diaphragm become inflamed or cause me pain because of my shortness of breathe. Is this a symptom of MG or something else? I have had CT Scan of upper abdomen (not the thoracic) and endoscopy. My doctor keeps thinking it is gastro related but It hurts more in the ribs, especially my right side. Thank you, Sharon T.
Thanks for your question. Myasthenia gravis (MG), as you probably know, is a pathology of the nerve-muscle interface, where the presence of auto-immune antibodies against neurotransmitter receptors doesn't allow the proper neural commands to reach the muscles, thus causing the weakness. It is a process that do NOT involve the sensory pathways. However, it is possible that in your case, an inadequate body posture from the axial weakness is causing the discomfort/pain described in your message. In particular, your symptoms appear to be very position dependent. A diaphragm muscle that is not moving appropriately can potentially result in focal atelectasis (small collapses) of the nearby pulmonary tissue, which in turn can result in pleural irritation. This situation would be easily seen in a good chest X-ray. You might discuss with your physician the necessity of some Physical Therapy exercises, and maybe the aid of supportive devices for the thoracic spine if the posture is indeed inadequate.
Thanks for your question. Altered sensations (such as numbness, tingling, pins and needles, etc.) can indeed be caused by peripheral sensory neuropathies. Although purely sensory neuropathies can occur, most peripheral neuropathies also present associated motor signs. On the other hand, it would be quite unusual for neurological impairment that results from multiple nerve root compressions ("pinched nerves") to manifest solely as sensory alterations, particularly at such extended areas, without any motor weakness signs. The lack of external dermatological signs (erythema, exanthemas, papules, I hope this information is helpful. Best of luck. This information is provided for general medical education purposes only.
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