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Correspondence to Author: Dr Priyanka V Kashyap ¹ , Dr Vaibhav O P Pandey ² , Dr Naman Sahu ³. 

1. Associate Professor, Department of Neurology, AIIMS, Bhopal;462026.
2. Senior Resident, Department of Neurology, AIIMS, Bhopal;462026.
3. Senior Resident, Department of Neurology, AIIMS, Bhopal;462026

DOI: 10.52338/tjocm.2026.5536

Abstract:

Introduction: Myasthenia gravis (MG) and related myasthenic syndromes show striking heterogeneity in phenotype, investigations, and treatment response, often complicating timely diagnosis and individualized management. We describe a series of four patients with myasthenic syndromes evaluated at AIIMS Bhopal, highlighting clinical presentation, key diagnostic work‑up (including antibody testing, neurophysiology, neuroimaging, and next‑generation sequencing when indicated), treatment strategies, and short‑term outcomes.
Case Reports: One acetylcholine receptor antibody–positive generalized MG patient developed impending myasthenic crisis precipitated by infection and suboptimal pyridostigmine dosing, improving with optimized anticholinesterase therapy, ventilatory support, intravenous immunoglobulin, and rituximab. A second patient with smoldering childhood onset ocular weakness with family history decoded at sixth decade. A third patient unveils approaching a chronic progressive external ophthalmoplegia (CPEO) phenotype. The fourth, an AChR‑positive MG patient prenting with sudden hemiparesis and how we approached.
Conclusion: This series underscores that ostensibly similar “myasthenic” presentations can reflect diverse autoimmune, genetic, and structural etiologies, and that meticulous clinical assessment, rational use of electrophysiology and genomics, and context‑sensitive therapeutic tailoring are crucial for optimal outcomes.

Keywords: Myasthenia Gravis, Myasthenic crisis, Congenital Myasthenic Syndrome, Glioma

Citation:

Dr. Priyanka V Kashyap, Myasthenia Gravis- Same Disease Yet Not SimilarA Case Series. The Journal of Clinical Medicine 2025.