We describe a 54-year-old man with myasthenia gravis, thymoma, systemic muscle twitch particularly of both lower limbs, hyperhidrosis and lower limb pain. The muscle twitch resembled to fasciculation rather than to myokymia and was persistent after discontinuation of anti-acetylcholinesterase drug. No attenuation nor disappearance of the muscle twitch was educed by spinal anesthesia. However, i...
