Vocal cord paralysis in myasthenia gravis following anesthesia

Our patient demonstrated two unusual features: (1) severe upper airway obstruction due to bilateral vocal cord paralysis at first manifestation of a myasthenic syndrome; and (2) precipitation of this syndrome following surgery and anesthesia with succinylcholine. In addition, this case illustrates use of ventilatory measurements through an endotracheal tube for documenting the patient's progress and response to medications, most dramatically during performance of an edrophonium test.