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Neurology (Expert Forum)
Questionable MG
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Questionable MG
by grace77, Jan 25, 2005 12:00AM
I have been dx'ed with a myopathy- trying to rule out Mg or some other metabolic/mitochondrial myopathy. My EMG is abnl. I just had a muscle bx- waiting on results. I had PFT's 5 years ago( which were normal then) and had them repeated 2 weeks ago. They showed moderately severe obstruction to air flow, diffusing capacity is markedly reduced,MVV was markedly reduced, and NIF was markedly reduced @ -10. My question is- I know some of these numbers reflect muscle weakness but I am also concerned about the decreased diffusion. How much should I attribute to muscle weakness and should I be having further testing to further evaluate the abnl values. I have dyspnea- like it is an effort to get a deep breath . My muscles fatigue easily but gets better with rest and have weakness in proximal muscles. I am on synthroid and my thyroid labs are normal.Does all this fit with a neuromuscular disease? I hate being in limbo and just want a dx so I can get treated and hopefully relieve my sxs.Do you have any suggestions for me as far as the next step? If it is respiratory muscle weakness- what is generally the treatment for such and can this be reversed or improved? Thanks for your help!
Doctor's Answer
by CCF-Neuro-M.D.-CS, Jan 26, 2005 12:00AM
Unfortunately I cannot give you a clinical diagnosis on the internet
If you have not discussed the PFTs with your doctor you probably should
The low diffusing capacity measures the ability of the lungs to transfer breathed in gas to the blood capillaries (in the test carbon monoxide is used)
If low together with an obstructive pattern, this is usually seen in the setting of emphysema - I have not seen your results and am not an expert on PFTs. If you smoke, for instance, this may account for some of the abnormalities.
The NIF is a better measure of your neuromuscular ability to breath, although can be falsly low if a poor effort is made in the test.
So treatment will depend on the reason why the results are abnormal - you need to see your doctor about this. If due to neuromuscular disease, treating the primary neuromuscular problem (like MG if it turns out that you have it), will improve the breathing
Good luck
If you have not discussed the PFTs with your doctor you probably should
The low diffusing capacity measures the ability of the lungs to transfer breathed in gas to the blood capillaries (in the test carbon monoxide is used)
If low together with an obstructive pattern, this is usually seen in the setting of emphysema - I have not seen your results and am not an expert on PFTs. If you smoke, for instance, this may account for some of the abnormalities.
The NIF is a better measure of your neuromuscular ability to breath, although can be falsly low if a poor effort is made in the test.
So treatment will depend on the reason why the results are abnormal - you need to see your doctor about this. If due to neuromuscular disease, treating the primary neuromuscular problem (like MG if it turns out that you have it), will improve the breathing
Good luck
