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Case Report

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J Korean Dysphagia Soc 2017; 7(2): 76-79

Published online July 30, 2017

Copyright © The Korean Dysphagia Society.

Dysphagia as the Only Manifestation of Myasthenia Gravis: A Case Report

Jung Ro Yoon, M.D., Jung Soo Lee, M.D., Ph.D., Yeo Hyung Kim, M.D.

Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Dysphagia is a common manifestation of myasthenia gravis (MG), but it has been rarely reported as the only symptom. We report a 46-year-old man who complained of dysphagia without any other symptoms. Based on a videofluoroscopic swallowing study (VFSS), he showed decreased tongue base retraction, premature bolus loss, and incomplete velopharyngeal closure. He also showed impaired laryngeal elevation that caused incomplete laryngeal closure and aspiration with a small amount of thin fluid. Laryngoscopic evaluations, brain magnetic resonance imaging, and repetitive nerve stimulation tests were unremarkable. Since the acetylcholine receptor antibody level was elevated, he was diagnosed with MG. Treatment with pyridostigmine was initiated and the dysphagia symptoms improved completely. MG is one possible cause of unexplained dysphagia. Therefore, neurological examination is required when abnormal findings are observed in VFSS, and evaluations for MG may be important for the final diagnosis.

Keywords: Deglutition disorder, Early diagnosis, Fluoroscopy, Myasthenia gravis

Article

Case Report

J Korean Dysphagia Soc 2017; 7(2): 76-79

Published online July 30, 2017

Copyright © The Korean Dysphagia Society.

Dysphagia as the Only Manifestation of Myasthenia Gravis: A Case Report

Jung Ro Yoon, M.D., Jung Soo Lee, M.D., Ph.D., Yeo Hyung Kim, M.D.

Department of Rehabilitation Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea

Abstract

Dysphagia is a common manifestation of myasthenia gravis (MG), but it has been rarely reported as the only symptom. We report a 46-year-old man who complained of dysphagia without any other symptoms. Based on a videofluoroscopic swallowing study (VFSS), he showed decreased tongue base retraction, premature bolus loss, and incomplete velopharyngeal closure. He also showed impaired laryngeal elevation that caused incomplete laryngeal closure and aspiration with a small amount of thin fluid. Laryngoscopic evaluations, brain magnetic resonance imaging, and repetitive nerve stimulation tests were unremarkable. Since the acetylcholine receptor antibody level was elevated, he was diagnosed with MG. Treatment with pyridostigmine was initiated and the dysphagia symptoms improved completely. MG is one possible cause of unexplained dysphagia. Therefore, neurological examination is required when abnormal findings are observed in VFSS, and evaluations for MG may be important for the final diagnosis.

Keywords: Deglutition disorder, Early diagnosis, Fluoroscopy, Myasthenia gravis

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