Herein, we reported a case of spinal myoclonus following an ultrasound-guided suprascapular nerve block. A 58-year-old male patient who had a diagnosis of calcific tendinitis inside the right supraspinatus tendon received a right suprascapular nerve block (3 mL of 2% prilocaine mixed with 2 mL of 1% lidocaine) under the guidance of ultrasound. Sudden, painless, and involuntary movements began in the upper extremity 10 min after the intervention. Three months after the injection, the involuntary movements were entirely stopped. Involuntary, painless, and brief muscle jerks may be suggestive of myoclonus after interventions with local anesthetics.

Aim To assess functions of the lower urinary tract (LUT) in patients with myasthenia gravis (MG). Materials and methods 36 patients (18 males and 18 females) with MG and 29 healthy controls were enrolled. Participants completed a 3-day voiding diary and responded to questionnaires "Overactive Bladder Symptom Score" (OABSS) and "International Consultation on Incontinence-Short Form" (ICIQ-SF). All patients underwent uroflowmetry and ultrasonography (US). The data were compared based on the onset of disease and serological status. Results The most common urinary symptoms were nocturia (80.5%), incontinence (61%), and urgency (47%). OABSS was higher in patients than controls (p= 0.008). Duration of urinary symptoms was longer and nocturia was more common in late-onset MG (LOMG) than in early-onset MG (EOMG) (p= 0.029, p= 0.023). The duration of disease and urinary symptoms statistically increased in ACh-Ab (-) group compared to ACh-Ab (+) group (p= 0.003, p= 0.027). Nighttime urination frequency significantly increased while daytime voided volume (VV) decreased in LOMG compared to EOMG (p= 0.003 and p= 0.01). Residual volume on the US was significantly higher in LOMG than that in EOMG (p= 0.004). The duration of disease was positively correlated with tQmax and daytime urination frequency (p= 0.013, r= 0.48; p= 0.016, r= 0.398). A negative association was found between duration of disease and daytime VV (p= 0.04, r= -0.344). Conclusion LUT dysfunction may manifest disease in MG, particularly in late-onset forms. The lack of ACh-Ab seemed to prolong the duration of disease and urinary disturbances.

The Medical Bulletin of Sisli Etfal Hospital