Myasthenic Syndrome with Associated Neuropathy

Abstract

Defects in neuromuscular transmission suggestive of myasthenia gravis have been found in association with a wide variety of disorders, including hyperthyroidism,^1-8myopathies,^9-10lupus erythematosis,^11-12malignancy,^13-15and polymyositis.¹⁶A similar relationship has been reported in various neuropathies, viz., poliomyelitis,^17-19syringomyelia,^1,20amyotrophic lateral sclerosis,^2,16,18,21and a variety of other conditions affecting the anterior horn cells²²; however, in none of these cases did myasthenia gravis appear as the primary disease. This report is a study of a patient with apparent myasthenia gravis who developed striking resistance to conventional therapy, who ultimately proved to respond in part to repeated courses of "rest" therapy with curare, and who late in her illness showed unexpected evidence of motor neuron disease. <h3>Report of Case</h3> During November, 1955, it was noted that the patient, a previously healthy 12-year-old girl, was unable to smile, and that the corners of