Misdiagnosis of Myasthenia Gravis and Subsequent Clinical Implication : A case report and review of literature

Abdullah Al-Asmi, Ramachandiran Nandhagopal, P C Jacob, Arunodaya Gujjar

Abstract


The autoimmune disease, myasthenia gravis (MG), can mimic a variety of neurological disorders leading to a delay in diagnosis and treatment. On occasions, misdiagnosis of MG could lead to unnecessary and potentially harmful therapeutic interventions. We report on a 12 year-old boy, in whom MG was mistaken for meningitic sequelae and subsequently for critical neuropathy/myopathy resulting in considerable morbidity for nearly a decade. Subsequent correct diagnosis and optimal management resulted in significant improvement in his functional status. We discuss the importance of considering MG as one of the potential differential diagnoses among cases of recurrent respiratory pump failure, or unexplained bulbar symptoms where documentary proof of the previous diagnoses including work-up for MG is lacking.  We also review the literature on MG misdiagnosis and highlight the potential pitfalls in MG diagnosis.



Keywords


Myasthenia gravis; Bulbar palsy; Pneumonia; Meningitis, sequelae; Case report; Oman.

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Sultan Qaboos University Medical Journal, College of Medicine and Health Sciences, Sultan Qaboos University, PO Box 35, Postal Code 123, Al-Khod, Muscat, Oman

ISSN (Print edition): 2075-051X ISSN (Internet edition): 2075-0528

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