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Myasthenia Gravis

Tongue and dizziness issues

02/02/2009

Question:

I was diagnosed with MG in June 2008 after onset of vertical diplopia. I was prescribed Mestinon and all was well until mid August when I began experiencing general weakness/fatigue. I now frequently feel dizzy and numbness at the base of my tongue. My neurologist and primary physician believe the tongue issue is not related to MG. They believe it`s neuropathy (nerve damage) from a herpes sore on my tongue in August. They also believe the Mestinon is not the cause of my dizzieness, since I had no issues with it prior to September and when I was off Mestinon as a trial for three weeks I still felt dizzy. Do you have any experience with MG patients with these symptoms?

Answer:

I also would say that the tongue numbness is not the myasthenia. Myasthenia should not have sensory symptoms—it is a disease of nerve to muscle and motor strength. I have not had a patient describe dizziness to me from the mestinon. My thoughts would be are there three separate problems (double vision, dizziness, and tongue numbness) or is there another process going on to explain all three? Could there be myasthenia, and another process causing the dizziness and the tongue numbness? Could there be something in the back of the brain to at least explain the dizziness and the numb tongue? Discuss again with your neurologist, but I agree with him/her that the myasthenia is not the cause of the numb tongue or dizziness. Good luck.

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Response by:

Robert W Neel, IV, MD Robert W Neel, IV, MD
Assistant Professor of Neurology
College of Medicine
University of Cincinnati