Effects of intravascular photobiomodulation on motor deficits and brain perfusion images in intractable myasthenia gravis: A case report

Figure 1 Myasthenia gravis activities of daily living scale. The symptoms of the patient with myasthenia gravis, including difficulties in talking, chewing, breathing, brushing teeth, and combing hair, as well as double vision were greatly ameliorated after intravascular laser irradiation of blood intervention, with grades dropping to zero. Swallowing, rising from a chair, and eyelid droop also showed good progress. MG-ADL: Myasthenia gravis activities of daily living; ILIB: Intravascular laser irradiation of blood.

Figure 2 Quantitative myasthenia gravis scale. The effect of intravascular laser irradiation of blood was measured using 13 criteria of the quantitative myasthenia gravis scale. MG: Myasthenia gravis; ILIB: Intravascular laser irradiation of blood.

Figure 3 Regional perfusion brain single-photon emission computed tomography before and after therapeutic intravascular laser irradiation of blood intervention (sagittal view). The white to red and green to blue areas indicate high and low perfusion, respectively. A:The first single-photon emission computed tomography (SPECT) (before ILIB intervention) shows perfusion deficits in the frontal lobe (white arrows); B: The second SPECT [after the third course of intravascular laser irradiation of blood (ILIB) intervention] shows more blood flow in the frontal lobe (white arrows). ILIB: Intravascular laser irradiation of blood.

Figure 4 Regional perfusion brain single-photon emission computed tomography before and after therapeutic intravascular laser irradiation of blood intervention (coronal view). The white to red and green to blue areas indicate high and low perfusion, respectively. A: The first SPECT (before ILIB intervention) shows perfusion deficits at the anterior cingulate gyri (white arrows); B: The second SPECT (after the third course of ILIB intervention) shows high activity in the anterior cingulate gyri (black arrows). ILIB: Intravascular laser irradiation of blood; SPECT: Single-photon emission computed tomography.

Figure 5 Time course of the case and the patient’s reported symptoms. IVIG: Intravenous immunoglobulin; OPD: Outpatient department; SPECT: Single-photon emission computed tomography; ILIB: Intravascular laser irradiation of blood; MG-ADL: Myasthenia gravis activities of daily living; QMG: Quantitative myasthenia gravis.