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Asymmetric pattern in generalized myasthenia gravis: A case report
Thiago Pereira de Carvalho1,2, Clara Louise Vianna1, Felipe Freitas Andrade2
1Alcides Carneiro Hospital.
Medicine
|December 15, 2018
Summary
Myasthenia gravis (MG) can present with unusual asymmetric limb weakness, challenging diagnosis. Prompt treatment with pyridostigmine and immunoglobulin led to symptom resolution in this case.
Area of Science:
- Neurology
- Autoimmunology
Background:
- Myasthenia gravis (MG) is an autoimmune disorder affecting neuromuscular junctions.
- Antibodies against acetylcholine receptors (AchRs) cause fluctuating muscle weakness.
Observation:
- A 32-year-old woman with MG presented with severe dysphagia, dysphonia, diplopia, and asymmetric tetraparesis.
- Viral gastroenteritis preceded symptom exacerbation.
Findings:
- Elevated anti-AchR antibodies and a thymic remnant were noted.
- Treatment with pyridostigmine and human immunoglobulin resulted in complete symptom resolution.
Implications:
- Asymmetric limb weakness is an unusual MG presentation that warrants suspicion.
- Brain MRI is crucial for ruling out other neurological conditions.
- This case highlights atypical manifestations of myasthenia gravis.
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