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Images of Memorable Cases: Case 104

Module by: Herbert L. Fred, MD, Hendrik A. van Dijk

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Case_104-pres1-1.jpg1:00 PM

Case_104-pres1-2.jpg 1:02 PM

Case_104-pres1-3.jpg 1:09 PM

104. Myasthenia gravis

This 25-year-old man presented with bilateral ptosis (greater on the left) and diplopia. He also complained of generalized weakness that worsened as effort increased or as the day progressed.

The images depict the patient showing a positive response to edrophonium chloride (Tensilon). His assay for acetylcholine-receptor antibodies—a test specific for myasthenia gravis—was also positive. He underwent thymectomy (image below) and subsequently functioned well with maintenance corticosteroid therapy.

Case_104-diag1-1.jpg

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