An Atypical Case of Myasthenia Gravis: Purely Bulbar in a Young Male

Abstract

Myasthenia Gravis (MG), an uncommon autoimmune syndrome caused by the failure of neuromuscular transmission, results from bind- ing of autoantibodies to proteins that are involved in signaling at the neuromuscular junction (1). Ac- quired myasthenia gravis (MG) is an uncommon disorder (occurring in 200–400 cases per million people) (2). Its symptoms are caused by a character- istic muscle weakness that worsens after repeated use. In most cases of MG, the initial sign is ocular weakness of any sort. The next most common sign is bulbar weakness (5) . In about two-thirds of pa- tients, the extrinsic ocular muscles (EOMs) present with the initial symptoms. These symptoms usually progress to other bulbar muscles and limb muscles, resulting in generalized MG (gMG). In about 10% of MG patients, symptoms remain limited to the EOM, and this condition is termed ocular MG (oMG)(3,4). However in cases where weakening of other stri- ated skeletal muscles occurs, this is referred to as generalized MG. We present a rare case of early onset Myasthenia Gravis affecting a young male with only and purely bulbar involvement.