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Vol. 56. Issue 1.
Pages 10-16 (1 January 2002)
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Vol. 56. Issue 1.
Pages 10-16 (1 January 2002)
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Síndromes miasténicos congénitos. Valoración clínica y electromiográfica
Congenital Myasthenic Syndromes. Clinical and Electrophysiological Evaluation
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M.A. Martin Santidrian
J.M.a Prats Viñas
Corresponding author
jprats@hcru.osakidetza.net

Correspondencia: Dr. J.M.a Prats Viñas. Unidad de Neuropediatría. Departamento de Pediatría. Hospital de Cruces, s/n. 48903 Baracaldo. Bilbao
C. Garaizar Axpe, C. Ruiz Espinosa
Unidad de Neuropediatría. Departamento de Pediatría. Hospital de Cruces. Bilbao.
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Antecedentes

Los síndromes miasténicos congénitos son los defectos de la transmisión neuromuscular más frecuentes en la infancia. Causan hipotonía, debilidad e insuficiencia respiratoria que puede conllevar graves consecuencias. Su filiación exacta requiere sofisticadas técnicas, que no se encuentran al alcance de la mayoría de los hospitales.

Objetivo

Aportar evidencias sobre el hecho de que la clínica la estimulación repetitiva dan soporte orientan el diagnóstico adecuado, en ausencia de técnicas invasivas.

Métodos

Selección de todos los pacientes con diagnóstico de síndrome miasténico congénito. La muestra está formada por cuatro niñas: dos defectos de resíntesis movilización de la acetilcolina (miastenia familiar infantil), un defecto de la enzima acetilcolinesterasa un déficit de receptor. Se describen en detalle las características clínicas electromiográficas de cada grupo, así como las peculiaridades de los pacientes.

Conclusiones

El fenotipo clínico la estimulación repetitiva permiten reconocer los síndromes miasténicos más frecuentes para evitar la realización de técnicas agresivas, anticiparse a las exacerbaciones respiratorias causa potencial de muerte, evitar la iatrogenia terapéutica aportar consejo genético.

Palabras clave:
Síndrome miasténico congénito
Miastenia
Neuropediatría
Unión neuromuscular
Estimulación repetitiva
Background

Congenital myasthenic syndromes are the more frequent group of disorders involving neuromuscular transmission in childhood. They are characterized by hypotonia, weakness and periodic apneic spells, which can be life threatening. Further elucidation of the causes of these syndromes requires sophisticated technology, which is not available in all hospitals.

Objective

To provide evidence that clinical features and repetitive stimulation support and guide the correct diagnosis in the absence of invasive techniques.

Methods

All the patients diagnosed with congenital myasthenic syndrome were selected. The sample consisted of four children: two with a defect in acetylcholine resynthesis and mobilization (familial infantile myasthenia), one with absence of the endplate-specific form of acetylcholinesterase and one with acetylcholine receptor deficit. The clinical and electromyographic features of these syndromes are described in detail.

Conclusions

Clinical phenotypes and repetitive stimulation can be used to classify the most common myasthenic syndromes and to avoid more aggressive techniques, predict potentially life threatening respiratory exacerbations and avoid iatrogenic effects. They can also be used in genetic counseling.

Key words:
Congenital myasthenic syndrome
Myasthenia
Neuropediatrics
Neuromuscular junction
Repetitive nerve stimulation
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