Dysphagia as the Sole Presentation in Myasthenia Gravis: A Rare Case of an Uncommon Disorder

Myasthenia gravis is the most common disorder of neuromuscular transmission, but bulbar symptoms as the sole presentation is relatively uncommon. Herein, we report a 25-year-old woman with bulbar myasthenia gravis that progressed to a myasthenia crisis. She visited the emergency department because of involuntary weight loss due to oropharyngeal dysphagia. The diagnosis of myasthenia gravis was confirmed by a positive serum acetylcholine receptor antibody test. Our patient suffered from a myasthenic crisis and aspiration pneumonia, which were successfully treated by plasmapheresis and antibiotics. It is worth emphasizing that bulbar MG is a true neurological emergency and should be seriously considered in young women who present with dysphagia. Early specialist consultation and the initiation of appropriate treatment should be carried out.