Abstract:
ABSTRACT
Myasthenia gravis (MG) is a chronic neuromuscular junction (NMJ) dysfunction with a wide
spectrum of neurological manifestations. MG is as a result of autoantibodies directed against NMJ
at the postsynaptic level involving nicotinic or other postsynaptic antigens. The newly identified
subtype of MG with antibodies against the muscle-specific receptor tyrosine kinase (Anti-MuSK)
shows an unpredictable response to current MG treatment. The initial presentation of this disease
entity often poses a diagnostic challenge and a treatment dilemma to the clinician. We present a
case of life threatening Anti-MuSK-positive myasthenic crisis occurring during puerperium which
required a temporary surgical airway and percutaneous endoscopic gastrostomy tube for feeding.
She had dysphonia for 7 years but was not diagnosed. The complications and management
dilemma of this case report are highlighted.
