A Case Report of Atypical Presentation of Myasthenia Gravis

Abstract

A group of autoimmune illnesses called anti-acetylcholine receptor antibody-mediated neuromuscular junction damage includes myasthenia gravis (MG). It is a fairly rare condition that affects more women than men.  Ptosis, and, less frequently, dysphagia or dysphonia, are the characteristic symptoms. Although it's uncommon, this illness can impact any skeletal muscle, such as the neck or the muscles of the proximal limbs. No cases of MG manifesting as a solitary neck weakness have been documented. A female patient, age 79, was seen with neck weakness and minor discomfort that got worse over the course of the day.Only the cervical muscles' motor strength was diminished upon examination. Except for anti AchR antibodies (binding Ab 13.04 nmol/L, blocking Ab 54% while modifying Ab 84%) with mildly raised (CPK) concentrations (360 U/l), all radiological and laboratory tests were within normal ranges. Pyridostigmine, which was supplied to the patient as 60 mg QID, quickly and significantly relieved the patient's neck weakness. Since taking the drug for two years, the patient has indeed been stable. MG mainly affects females in their middle years, but it sporadically affects older people as well. To cut down on expenses and morbidity associated with investigations, physicians should have a high degree of suspect for myasthenia manifesting with fatigable muscle weakness.