Myasthenia gravis in a collegiate football player

A 17-yr-old Division I-AA collegiate offensive lineman developed unilateral ptosis shortly after minor head trauma during a scrimmage. The subsequent temporal profile of the ptosis, a history of a similar event lasting a short period of time 2 yr earlier, and the results of his clinical and electrop...

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Bibliographic Details
Published in:Medicine and science in sports and exercise 2000-12, Vol.32 (12), p.1975-1979
Main Authors: LEDDY, John J, CHUTKOW, Jerry G
Format: Article
Language:English
Subjects:
Adolescent
athletes
Athletic Injuries - complications
Biological and medical sciences
Blepharoptosis - etiology
Diseases of striated muscles. Neuromuscular diseases
football
Football - injuries
Glucocorticoids - therapeutic use
Humans
Male
Medical sciences
myasthenia gravis
Myasthenia Gravis - diagnosis
Myasthenia Gravis - drug therapy
Myasthenia Gravis - therapy
Neurology
Prednisone - therapeutic use
Space life sciences
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Summary:A 17-yr-old Division I-AA collegiate offensive lineman developed unilateral ptosis shortly after minor head trauma during a scrimmage. The subsequent temporal profile of the ptosis, a history of a similar event lasting a short period of time 2 yr earlier, and the results of his clinical and electrophysiologic examinations established a diagnosis of very mild, generalized, antibody-negative myasthenia gravis (MG). His desire to continue playing football posed several additional management problems for which there was no published guidance. We started him on alternate-day, high-dose prednisone therapy with potassium and calcium supplementation, and allowed him to partake in conditioning but no contact. Except for residual decreased exercise tolerance, he improved symptomatically and experienced no serious adverse effects from the illness or the treatment during his first season, despite imperfect drug compliance. His MG eventually came under excellent symptomatic control, allowing initiation of a slow taper of the prednisone before his second season. Shortly thereafter, he abruptly stopped the prednisone without seeking medical advice. He continued to experience mild left ptosis and a mild decrease in intense exercise tolerance. He decided to forego his senior season of collegiate football after a bout of severe mechanical low-back pain incurred during spring football practice and limited his athletic activity thereafter to recreational sports.
ISSN:0195-9131
1530-0315
DOI:10.1097/00005768-200012000-00001