Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Aug 26, 2022; 10(24): 8718-8727
Published online Aug 26, 2022. doi: 10.12998/wjcc.v10.i24.8718
Effects of intravascular photobiomodulation on motor deficits and brain perfusion images in intractable myasthenia gravis: A case report
Chiao-Hsin Lan, Yu-Che Wu, Cheng-Chun Chiang, Shin-Tsu Chang
Chiao-Hsin Lan, Cheng-Chun Chiang, Shin-Tsu Chang, School of Medicine, National Defense Medical Center, Taipei 114201, Taiwan
Yu-Che Wu, Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
Shin-Tsu Chang, Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, Kaohsiung 813414, Taiwan
Shin-Tsu Chang, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei 114202, Taiwan
Author contributions: Lan CH reviewed the literature and contributed to manuscript drafting; Lan CH, Wu YC, and Chiang CC analyzed and interpreted the imaging findings; Chang ST were responsible for the revision of the manuscript for important intellectual content and supervised the study and managed the project; and All authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Shin-Tsu Chang, MD, MS, PhD, Director, Department of Physical Medicine and Rehabilitation, Kaohsiung Veterans General Hospital, No. 386 Dazhong 1st Road, Zuoying District, Kaohsiung 813414, Taiwan. ccdivlaser1959@gmail.com
Received: March 14, 2022
Peer-review started: March 14, 2022
First decision: May 11, 2022
Revised: May 24, 2022
Accepted: July 16, 2022
Article in press: July 16, 2022
Published online: August 26, 2022
Processing time: 155 Days and 0.2 Hours
Abstract
BACKGROUND

Myasthenia gravis (MG) is an autoimmune disorder caused by neuromuscular junction failure characterized by muscle weakness and fatigability. We herein report a case of MG that received intravascular laser irradiation of blood (ILIB) interventions and regained muscle power and better quality of life. To our knowledge, no previous study has investigated the benefits of ILIB treatment on patients with MG. We also evaluated the changes in brain perfusion scan and the MG activities of daily living (MG-ADL) and quantitative MG (QMG) scales.

CASE SUMMARY

A 59-year-old man presented to our outpatient hospital experiencing ptosis, diplopia, fibromyalgia, muscle fatigue, and fluctuating weakness in his limbs for 1 year. Based on his history, physical examination, and laboratory investigations, the final diagnosis was a flare-up of MG with poor endurance and muscle fatigue. The patient agreed to receive ILIB. Brain single-photon emission computed tomography (SPECT) was performed both before and after ILIB therapy. After receiving three courses of ILIB, the brain SPECT images showed greatly increased perfusion of the frontal lobe and anterior cingulate gyri. The patient’s MG-ADL scale score decreased markedly from 17/24 to 3/24. The QMG scale score also decreased remarkably from 32/39 to 9/39. The symptoms of MG became barely detectable and the patient was able to perform his activities of daily living and regain muscle power.

CONCLUSION

ILIB might have beneficial effects on MG, and brain SPECT images provided direct evidence of a positive correlation between ILIB and clinical performance.

Keywords: Myasthenia gravis; Intravascular laser irradiation of blood; Myasthenia gravisactivities of daily living scale; Quantitative myasthenia gravis scale; Single-photon emission computed tomography; Case report

Core Tip: Myasthenia gravis (MG) is an autoimmune disease without effective treatments. We herein report a case of intractable MG administered a novel therapy, intravascular laser irradiation of blood interventions (ILIB), which regained muscle power and improved quality of life. To our knowledge, this is the first study investigating the benefits of ILIB treatment in patients with MG. We also evaluated the changes in brain perfusion scan and MG activities of daily living scale, and quantitative MG scale scores. We report this case to trigger further research and facilitate the recovery of patients with MG.