Facial diplegia, progressive bulbar weakness and tongue fasciculation without ocular involvement in myasthenia gravis: a case report
Keywords:
Bulbar weakness, Facial diplegia, Myasthenia Gravis, Tongue fasiculationAbstract
Background: Juvenile Myasthenia Gravis (MG) is an immune-mediated disorder caused by antibodies against the post-synaptic membrane at the neuromuscular junction, typically presenting with fatigable weakness and ptosis. Although the clinical phenotypes of juvenile myasthenia gravis are similar to those in adults, several factors impact its management, including a broader range of differential diagnoses, atypical features, and higher rates of disease remission.
Case Report: We present a case of an adolescent boy with myasthenia gravis who experienced progressive bulbar weakness, facial diplegia, and tongue fasciculations without ocular involvement or significant limb issues, posing a diagnostic challenge. Due to bulbar involvement and aspiration pneumonia requiring hospitalization, a notable diurnal variation in secretion severity between morning and evening suggested a diagnosis of MG.
Conclusion: Recognition of myasthenia gravis with atypical features is crucial in preventing diagnostic delays and avoiding progressive disability and complications, such as myasthenic crises.
Keywords: Bulbar Palsy, Facial Diplegia, Juvenile Myasthenia Gravis, Tongue Fasciculation
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Copyright (c) 2024 Javeria Raza Alvi, Arshad Mehmood, Tipu Sultan, M Zia ur Rehman, Samreen Ashraf, Nighat Sultana (Author)
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