Myasthenia gravis with motor neurone disease

A 56 year old male presented with features of easy f atiguability, episodic hoarseness and nasal quality of voice accompanied by nasal regurgitation of liquids for three years. Neurological examination revealed lingual atrophy with fasciculations, pyramidal tract signs and features of neuromuscular junction dysfunction. Moreover, CT scanning of thorax revealed thymic enlargement. The co-occurrence of myasthenia gravis with motor neurone disease is being reported for its rarity.