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Published on: November 1, 2024
Extensive Postradiation Ocular and Diffuse Cranial Neuromyotonia Mimicking Myasthenia Gravis
Todd A Hardy1, Andrew W Lee, Con Yiannikas
1*Neuroimmunology Clinic, Concord Hospital §ANZAC Research Institute, University of Sydney, Sydney, NSW Departments of †Neurology ‡Ophthalmology, Flinders Medical Centre, Flinders University, Adelaide, SA, Australia.
Background:
Ocular neuromyotonia is a rare, but well-recognized, complication of cranial irradiation.
Case Report:
Using figures and videos, we report a 52-year-old man with extensive ocular, brainstem, and lower cranial nerve neuromyotonia postradiation therapy for a fourth ventricle glioma who, in the context of an apparently positive edrophonium test, was initially misdiagnosed with myasthenia gravis.
Conclusions:
This is the first case of postirradiation neuromyotonia to be reported with such extensive cranial nerve and brainstem involvement.
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