Myasthenia gravis with myasthenic crisis: a case report

Abstract

Objective: To present a favorable outcome in a Myasthenia gravis (MG) patient with myasthenic crisis and discuss its main diagnostic challenges. Case detail: We report the case of a previously healthy 80-year-old male who first presented with dysphagia that quickly progressed to a generalized myasthenic syndrome leading to ICU admission and intubation over the course of less than two months. He was investigated firstly for thymoma, followed by Parkinson’s disease and Lambert-Eaton syndrome before closing on MG. He was successfully stabilized after a month-long ICU stay intercurring with multiple infections and respiratory failure. Currently presenting no sequalae or recurrence. Final considerations: Myasthenia gravis is an important autoimmune neuromuscular disorder that affects the neuromuscular junction. It has many possible signs and symptoms, depending on the most affected muscle group. Although there is no cure for it, an early diagnosis allows an approach and treatment that provides a better quality of life, and the prevention of related complications. We discuss how to assess the main differential diagnoses, including Parkinson’s disease, Amyotrophic Lateral Sclerosis, Multiple Sclerosis, Lambert-Eaton Syndrome, and others, to help clinicians facing a similar patient and avoid a poor outcome on a fast-paced progression case such as the one we report.