Li W, He L, Jin X, Li L, Sun C, Wang C. Isolated dysarthria as the sole manifestation of myasthenia gravis: a case report.
J Int Med Res 2022;
50:3000605221109395. [PMID:
35915860 PMCID:
PMC9350514 DOI:
10.1177/03000605221109395]
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Abstract
Myasthenia gravis (MG) is an acquired autoimmune disease. Its clinical
manifestations comprise ptosis, diplopia, dysarthria, dysphagia, limb weakness,
and in severe cases, respiratory muscle involvement. Dysarthria as an exclusive
initial and primary complaint in MG is rare and seldom reported. In this paper,
we report a case of type IIIb MG with isolated dysarthria as the only clinical
manifestation and we review the relevant literature. The patient was a
62-year-old man who presented with episodes of slurred speech for 20 days that
had worsened in the previous 9 days. His medical history comprised hypertension,
diabetes mellitus, and coronary heart disease. The initial diagnosis on
admission was transient ischemic attack. Careful re-examination of the patient’s
history revealed that his symptoms mainly involved increasingly worse slurred
speech episodes without drinking or swallowing difficulties, and no significant
improvement with rest was observed. Electromyography and autoantibody profiling
led to a diagnosis of type IIIb MG. His symptoms improved after the oral
administration of pyridostigmine bromide 60 mg. Laryngeal MG is important to
differentiate from stroke. It is necessary to perform a computerized voice
analysis when encountering patients with atypical symptoms of MG.
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