Abstract
We report a young girl with myasthenia gravis (MG) who was first seen at age 2 for unexplained falls, diplopia, and ptosis. The patient was born as a full-term spontaneous vaginal delivery and spoke her first words and started walking at the age 10 months. The child was physically active initially and loved to play and run. At age 27 months, the patient started having difficulty rising up while she was lying or sitting. She also experienced increasing difficulty swallowing without any dyspnea. Diagnostic workup at age 2 revealed a positive neostigmine test with improved muscle strength. Electromyography showed a decrement of 20 to 28% with 3- and 10-Hz repetitive stimulation in two nerve muscle pairs; anti-acetylcholine receptor antibody (anti-AChR Ab) levels were 0.6 and 1.3 on consecutive testing (N 0 to 0.4). Chest radiograph and CT scan did not reveal any additional findings. …
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