Rippling Muscles and Myasthenia Gravis With Rippling Muscles

doi:10.1001/archneur.1996.00550020113023

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Vol. 53 No. 2, February 1996

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Rippling Muscles and Myasthenia Gravis With Rippling Muscles

Carl F. Ansevin, MD; Dimitris P. Agamanolis, MD

Arch Neurol. 1996;53(2):197-199.

Abstract

Objective
To describe a patient with rippling muscles and myasthenia gravis.

Design
Clinical, laboratory, electrophysiologic, and muscle biopsydata are reported.

Setting
Medical office and hospital.

Patient
We describe a patient with rippling muscles (as seen in ripplingmuscle disease) and myasthenia gravis (MG) with thymoma. Therewas no family history of rippling muscle disease in our patient.Diplopia and other symptoms of MG were initially overshadowedby the striking rippling phenomenon. The rippling resolved whenthe MG became Horrid.

Interventions
The patient was treated with pyridostigmine, prednisone, andplasmaphereses before removal of a thymoma.

Main Outcome and Results
His MG improved with treatment and the rippling has not recurred4 months after thymectomy.

Conclusions
Rippling muscle disease is rare and usually inherited. Our patientwith rippling muscles (but no family history of rippling muscledisease) and MG suggests that rippling muscles may also be triggeredby an autoimmune phenomenon.

Author Affiliations

From the St Elizabeth's Medical Center, Youngstown, Ohio (Dr Ansevin); and Akron Children's Hospital, Akron, Ohio (Dr Agamanolis)

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