[Fiber endoscopic evaluation of swallowing (FEES) - an important tool for diagnosing myasthenia gravis]

A 76-year old man was admitted with a globus sensation and weight loss for further investigations to our geriatric ward. A gastroscopic evaluation executed before had been unremarkable.

Physical examination was unremarkable, including a neurological examination.

All radiological findings (computer tomography of chest, abdomen and neck) were unremarkable. In a FEES investigation we found retentions and a reduction of frequency of swallowing after a while. During the investigation the patient complained about a muscular weakness in his neck. The assumed diagnosis of a myasthenia gravis was confirmed by antibodies against acetylcholine receptors and a decrement in repetitive irritation of the orbicularis and trapezius muscle.

FEES can be a valid diagnosis tool for a pharyngeal type of a myasthenia gravis.