A 49-year-old female presents with ptosis, diplopia and dysphagia and is diagnosed with myasthenia gravis by electromyography (Figure 1). The patient reports some improvement of her symptoms with pyridostigmine, but due to increasing symptoms, she has been placed on prednisone and mycophenolate mofetil. She is otherwise healthy and takes no other medications. Computed tomography imaging shows n...

Myasthenia gravis and hypokalemic periodic paralysis are commonly related with hyperthyroidism but rarely occur together. Here, the authors reported a case of hypokalemic periodic paralysis in a Northeastern Thai woman accompanied with myasthenia gravis. She had motor weakness despite a normal level of serum potassium. Prostigmine test was positive. She dramatically improved after pyridostigmin...

We report the case of an unusual presentation of myasthenia gravis with tongue atrophy and fasciculation. Myasthenia gravis is an autoimmune condition associated with weakness and fatigability of voluntary muscles. In >50%, the initial symptoms and signs are related to extraocular muscle weakness, such as diplopia or ptosis [Tsung K, Seggev JS. An unusual cause of dysphagia. West J Med 1995; 16...

A female patient with a three year history of Crohn's disease of the colon developed myasthenia gravis. Despite diversion of the faecal stream by an ileostomy, and total colectomy, the patient had continuing problems with perineal and perianal abscesses and fistulas. Her myasthenia gravis became unresponsive to anti-cholinergics so a thymectomy was performed. The perineal and perianal disease i...

Drug-induced myasthenic syndromes are caused by numerous medications of various classes. D-penicillamine and interferon alpha lead to an autoimmune process similar to spontaneous myasthenia gravis, whereas many other agents produce weakness by a direct compromise of neuromuscular transmission. A particular problem in clinical practice is the deterioration of neuromuscular transmission by anesth...

Myasthenia gravis is an acquired chronic autoimmune disorder caused by decrease in functioning of acetylcholine receptors at the neuromuscular junctions owing to their destruction or inactivation by circulating antibodies. Disease manifests in the form of easy fatigability, weakness, difficulty in swallowing and even paralysis of respiratory muscles necessitating assisted ventilation. The clini...

In patients presenting with eyelid ptosis the clinician considers a differential diagnosis of 3rd nerve palsy, Horner’s syndrome, mitochondrial myopathy, oculopharyngeal muscular dystrophy, levator dehiscence, myotonic dystrophy and myasthenia gravis. The presence of moment to moment fluctuation in severity of ptosis (fatigable ptosis) typically suggests a neuromuscular junction disorder of whi...

Complete removal of the thymus and fatty tissue adherent to pericardium is crucial for treating myasthenia gravis. Our aim was to analyze our surgical and clinical results and early experience of robot-assisted thymectomy in patients with nonthymomatous myasthenia gravis. Between January 2008 and October 2010, 8 patients, all women, with nonthymomatous myasthenia gravis underwent robot-assisted...

Myasthenia Gravis (MG) in the elderly is an uncommon finding, especially when it is not related to thymoma. A case is presented with late onset Myasthenia Gravis treated with steroids, immunosuppressives and mechanical ventilation. This 61 year Asian hypertensive lady clinically diagnosed as MG presented to emergency room with difficulty in swallowing liquid, diplopia, drooping of eyelids and g...

OBJECTIVE To estimate jitter parameters in myasthenia gravis in stimulated frontalis and extensor digitorum muscles using the concentric needle electrode. METHODS Forty-two confirmed myasthenia gravis patients, being 22 males (aged 45.6±17.2 years-old) were studied. Jitter was expressed as the mean consecutive difference (MCD). RESULTS MCD in extensor digitorum was 61.6 µs (abnormal in 85.7...