Acute hemiparesis with hemichorea and crossed hemiparesis; unusual presentation for myasthenia gravis
Ong, B.K.; Chong, P.N.
Singapore Medical Journal 34(1): 60-61
1993
ISSN/ISBN: 0037-5675 PMID: 8266133 Document Number: 409202
Myasthenia gravis is an autoimmune disease mediated by antibodies directed against the acetylcholine receptor. Patients typically present with weakness and fatiguability involving predominantly ocular and bulbar muscles. We describe 2 patients with acute weakness, one with a left hemiparetic pattern and chorea, and the other with crossed left hemiparesis and right facial weakness. More typical features of generalized myasthenia developed with time and both had thymic follicular hyperplasia on thymic histopathology. Clinical improvement occurred in both following thymectomy and immunosuppression. These cases exemplify the fact that markedly asymmetric limb weakness can be an early feature of generalized myasthenia gravis.