{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,5]],"date-time":"2026-11-05T21:53:58Z","timestamp":1793915638611,"version":"4.8.0"},"reference-count":31,"publisher":"American Academy of Pediatrics (AAP)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,10,1]]},"abstract":"<jats:sec>\n                  <jats:title>OBJECTIVE:<\/jats:title>\n                  <jats:p>To evaluate the incidence, clinical features, diagnostic, and treatment trends of pediatric myasthenia in Canada.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>METHODS:<\/jats:title>\n                  <jats:p>Through established Canadian Pediatric Surveillance Program methodology, physicians were anonymously surveyed for cases of pediatric myasthenia using a standardized clinical questionnaire containing deidentified data. Inclusion criteria were any child &amp;lt;18 years old with \u22651 of the following: (1) fluctuating ptosis or extraocular weakness, (2) skeletal muscle weakness or fatigue, and (3) any of the following supportive tests: clinical response to acetylcholinesterase inhibitor, positive antibodies, abnormal slow repetitive nerve stimulation, or single-fiber electromyography.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS:<\/jats:title>\n                  <jats:p>In 2 years of surveillance, 57 confirmed cases were reported. There were 34 generalized and 18 ocular reports of juvenile myasthenia gravis plus 5 congenital myasthenic syndrome cases. There were 14 incident cases in 2010 and 6 in 2011. Age of onset ranged from \u201cbirth\u201d to 17 years for the generalized form compared with 18 months to 11 years for the ocular subtype. Positive acetylcholine receptor titers were found in 22 (67%) of 33 generalized cases and 8 (44%) of 18 ocular patients. Of patients started on pyridostigmine, improvement was noted in 33 (100%) of 33 generalized cases and 15 (88%) of 17 ocular cases.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS:<\/jats:title>\n                  <jats:p>This study represents the largest descriptive series of pediatric myasthenia in North America and provides valuable information about clinical characteristics. A high index of suspicion is important for this treatable disease. Children generally respond promptly to readily available therapies.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1542\/peds.2013-0814","type":"journal-article","created":{"date-parts":[[2013,9,10]],"date-time":"2013-09-10T00:40:08Z","timestamp":1378773608000},"page":"e939-e944","source":"Crossref","is-referenced-by-count":64,"title":["Clinical Characteristics of Pediatric Myasthenia: A Surveillance Study"],"prefix":"10.1542","volume":"132","author":[{"given":"Juliana","family":"VanderPluym","sequence":"first","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiri","family":"Vajsar","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, SickKids and University of Toronto, Toronto, Ontario, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francois Dominique","family":"Jacob","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean K.","family":"Mah","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Grenier","sequence":"additional","affiliation":[{"name":"Canadian Pediatric Society, Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Kolski","sequence":"additional","affiliation":[{"name":"Division of Neurology, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2013,10,1]]},"reference":[{"key":"2021121006544316900_B1","first-page":"336","article-title":"Zur Casuistik der bulbaren Lahmungen. 3 Ueber einen neuen, wahrscheinlich bulbaren Symptomencomplex.","volume":"9","author":"Erb","year":"1879","journal-title":"Arch Psychiatr Nervenkr"},{"issue":"10","key":"2021121006544316900_B2","doi-asserted-by":"crossref","first-page":"1888","DOI":"10.1212\/WNL.42.10.1888","article-title":"The epidemiology of myasthenia gravis in central and western Virginia.","volume":"42","author":"Phillips","year":"1992","journal-title":"Neurology"},{"issue":"4","key":"2021121006544316900_B3","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1136\/jnnp.2006.100545","article-title":"Clinical and serological study of myasthenia gravis in HuBei Province, China.","volume":"78","author":"Zhang","year":"2007","journal-title":"J Neurol Neurosurg Psychiatry"},{"issue":"5","key":"2021121006544316900_B4","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1002\/ana.410130506","article-title":"Myasthenia gravis in children: long-term follow-up.","volume":"13","author":"Rodriguez","year":"1983","journal-title":"Ann Neurol"},{"issue":"2","key":"2021121006544316900_B5","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1055\/s-2007-973544","article-title":"A case of myasthenia gravis in childhood associated with chronic inflammatory demyelinating polyradiculoneuropathy.","volume":"29","author":"Kimura","year":"1998","journal-title":"Neuropediatrics"},{"issue":"2","key":"2021121006544316900_B6","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1177\/088307389200700202","article-title":"Transient neonatal myasthenia gravis.","volume":"7","author":"Papazian","year":"1992","journal-title":"J Child Neurol"},{"issue":"1","key":"2021121006544316900_B7","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1055\/s-2004-829592","article-title":"Congenital myasthenic syndromes.","volume":"24","author":"Harper","year":"2004","journal-title":"Semin Neurol"},{"key":"2021121006544316900_B8","unstructured":"Statistics Canada. 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