1) Present your findings. 2) What is the diagnosis ?
3) Give reason for your answer.
4) What other differential diagnosis ?
5) What other signs would you look for ?
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4 comments:
1. The face is myopathic with wasting of frontalis muscles and bilateral ptosis.
2. Myotonic dystrophy
4. Myastenia Gravis
5. Percussion myotonia, bulbar dysartthria, cataract?
I would like to ask for eye surgery, dipstick urine for glucosuria, ECG for heart block and EMG.
1. This patient has wasting of temporalis, bilateral ptosis, bifacial weakness, wasting of masseter, elongated face and wasting of sternomastoid muscles.
2. Dystrophia Myotonica
3. The patient has characteristic facies (expressionless 'hatchet face') and 'swan neck'.
4. Myasthenia gravis, Facioscapulohumeral dystrophy, Guillain-Barre syndrome?
5. wasting of small muscles of hands, percussion myotonia over thenar muscles, cataracts, dysphagia, arrythmias, check blood sugar(diabetes mellitus),ask for family history of muscle weakness?
Great shuyu ! Well done !
Great shuyu ! Well done !
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