A case with myasthenia gravis, brain stem multiple infarcts, fracture of vertebrae Th6 and discal hernia to the Th7/Th8

Abstract

Background. We report the case of a patient with myasthenia gravis accompanied with brain stem multiple infarcts, fracture of vertebrae Th6 and discal hernia of the Th7/TH8.

Case report. A 66-year-old male patient, one week prior to the hospitalization showed up complaints of dizziness, nausea, vomiting, numbness of the left side of the face, swallowing difficulty, left side body weakness, right side of the body numbness starting from the nipples and going down to the right leg as well as general fatigue. Six years ago the patient was diagnosed with myasthenia gravis based on electrophysiological investigations, pharmacologic tests and findings of acetylcholine (Ach) receptor antibodies in serum. He was then treated with the following medications: pyridostigmine of 60mg x 5/day, prednisolon of 20 mg (every other day), azathioprine 100mg tid. He was doing well under described therapy. Twenty years ago his left kidney was removed due to calculosis. He had also a sister that suffered of myasthenia gravis and diabetes mellitus.

Conclusions. Myasthenia gravis has a number of symptoms and signs which probaly are in common with stroke-including fatigue, muscle weakness, slurred speach and swallowing difficulty. The reported case supports the opinion that several medical conditions such as brain steam stroke may mimick myasthenia gravis