周全性老年評估個案報告：一位以衰弱為臨床表現之老年發病重症肌無力的婦女

重症肌無力是影響神經肌肉交接處的自體免疫疾病，發病年齡傾向兩極化，隨著人口結構老化，近年來65歲以上老年發病重症肌無力之族群發生率有上升的趨勢，但許多未能被正確診斷。由於高齡長者較易有多重共病與多重用藥的情形，加上身體老化的變化，使得臨床醫師診斷老年重症肌無力時，需要面對鑑別診斷與治療選擇多面向考量的挑戰。本個案報告一名74歲老年女性，經歷數個月的全身無力、眼瞼下垂與疲勞，多次就醫檢查後，被告知症狀歸因於自然老化。而後至地區醫院高齡醫學門診求診，因個案有衰弱與部分工具性日常生活功能減退之老年症候群，進行周全性老年評估後高度懷疑是老年重症肌無力，經轉介醫學中心確診後，給予適當的口服藥物治療後，個案的症狀改善，其功能與獨立性也隨之恢復。

關鍵字

周全性老年評估；衰弱；重症肌無力；老年發病

並列摘要

Myasthenia Gravis is an autoimmune disorder of neuromuscular junction, which is more commonly identified in younger individuals. As population ages, Myasthenia Gravis in the elderly age group has reported an increased incidence but remained under-diagnosed. The impact of medical comorbidity and aging on the elderly population further renders the diagnosis and treatment of Myasthenia Gravis more complicated and challenging. In this article, a 74-year-old female had suffered from progressive general weakness, ptosis and malaise for months. She was told by doctors that her symptoms were related to normal aging so she visited the geriatric outpatient department of a community hospital and received comprehensive geriatric assessment. The results showed frailty with mild impaired instrumental daily activity, and elderly-onset Myasthenia Gravis was highly suspected. We referred her to a medical center, and the diagnosis was confirmed by serologic and electrophysiological tests. She received medical treatments and regained her function and independency.

並列關鍵字

comprehensive geriatric assessment ； frailty ； myasthenia gravis ； elderly onset

國際替代計量

周全性老年評估個案報告：一位以衰弱為臨床表現之老年發病重症肌無力的婦女

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