TITLE:
Serious Myasthenia at the Department of Internal Medicine of Point G University Teaching Hospital: A Clinical Case
AUTHORS:
Assétou Kaya Soukho, Djenebou Traoré, Adramé Keita, Djibril Sy, Guida Landouré, Seybou Hassane Diallo, Youssouf Fofana, Kaly Keita, Mamadou Mallé, Ibrahima Amadou Dembélé, Drissa Sangaré, Mamadou Cissoko, Barry Boubacar Sangaré, Mamadou Dembélé, Abdel Kader Traoré, Hamar Alassane Traoré
KEYWORDS:
Myasthenia, Immunoglobulin, Internal Medicine, Point G Hospital
JOURNAL NAME:
Neuroscience and Medicine,
Vol.10 No.3,
September
6,
2019
ABSTRACT: Introduction: Myasthenia is a rare and disabling autoimmune disease. Few studies were devoted to this pathology. We report a clinical case of myasthenia in the Department of Internal Medicine at the Point G University Teaching Hospital. Observation: This is a 41-year-old patient of Malian origin, a trader with a history of hemorrhoidectomy in 2011 and familial hypertension, was admitted on August 19, 2014, for muscle weakness, dysphonia, and dysphagia. The disease started 1 year before admission at the department with progressive muscle weakness of the upper limbs aggravated by repetitive movements and spreading to the head “drooping head” and inferior limbs, associated with general fatigue, dysphonia and selective dysphagia for solid foods. The diagnosis of myasthenia was maintained based on the clinical signs such as ptosis, bilateral diplopia, and weakness with lower limbs muscle strength rated at 3/5, and confirmed with confirmatory exams; a positive anti-acetylcholine receptor antibody (RIA), the post-synaptic neuromuscular conduction block at ENMG and the positive neostigmine pharmacological test. The patient received Neostigmine (prostagmine) 0.5 mg one ampoule in IM/day and Prednisone at a dosage of 1 mg/kg/day. The evolution was marked by a moderate improvement of the symptomatology afterward the patient was evacuated to Tunisia on family request where he received a course of immunoglobulin 2 g/kg in 2 days. The evolution in Tunisia was favorable. The patient returned in Mali and death occurred after 2 months in a context of respiratory distress. Conclusion: Myasthenia is a rare but serious disease requiring careful management and monitoring to reduce respiratory complications.