Miastenia gravis

Abstract

Myasthenia gravis is an autoimmune disorder that involves the production of antibodies, mostly aimed at the acetylcholine receptors in the neuromuscular junction, thereby producing a decrease in the number and density of these receptors, as well as the loss and simplification of the folds in the postsynaptic membrane. It is a rare condition, although the prevalence has increased, perhaps by improvement in the diagnosis of the disease. The most common clinical manifestation of Myasthenia Gravis is the fluctuating weakness and fatigue muscle that is increased with the effort, which involves mainly innervated muscles by the motor nuclei of the brain stem. The fundamental therapeutic measures are the anticholinesterases, corticosteroids, immunosuppressants, and thymectomy. The current prognosis of the disease is good and most of the patients will require long-term treatment though they may get a normal life. We present a clinical case of Myasthenia Gravis with unusual clinical manifestations, but with adequate response to treatment. The aim of this report is to present the possible variations in the presentation of this nosological entity that may lead to a wrong diagnosis. In spite of being a disease with specific clinical features, it has been described in the unusual literature symptoms in the anatomic distribution of the weakness and the early presence of atrophy; by consequently its diagnosis would become a true challenge for health-care personnel.