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Childhood Graves disease masquerading as myasthenia gravis

Seth J Perlman1, Craig M Zaidman

  • 11Department of Neurology, Washington University, St Louis, MO, USA.

Journal of Child Neurology
|September 7, 2012
PubMed

Insights

Graves disease can cause eye movement and eyelid problems in children. Treating the underlying hyperthyroidism resolved these symptoms, suggesting a link between the conditions.

Area of Science:

  • Pediatric Endocrinology
  • Ophthalmology
  • Neurology

Background:

  • Ophthalmoplegia, ptosis, and facial weakness can present diagnostic challenges in children.
  • Myasthenia gravis is a common consideration for these symptoms, but other causes should be explored.

Observation:

  • A child presented with intermittent ophthalmoplegia, fluctuating ptosis, and facial weakness.
  • Initial evaluations ruled out myasthenia gravis.
  • The child was diagnosed with hyperthyroidism secondary to Graves disease.

Findings:

  • Treatment of the child's hyperthyroidism led to complete resolution of the ophthalmoplegia, ptosis, and facial weakness.
  • This suggests a direct link between Graves disease and the presenting neurological symptoms.

Implications:

  • Children with ophthalmoplegia and ptosis, especially without proptosis, should be evaluated for hyperthyroidism.
  • This evaluation is crucial when myopathy or neuromuscular junction disorders are not evident.
  • Early diagnosis and management of Graves disease can prevent persistent or severe symptoms.

Keywords:
GravesGraves diseasehyperthyroidismmyasthenia gravisophthalmoplegiaptosisthyroid

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