A case of Myasthenia Gravis masquerading as GBS

Myasthenia gravis (MG) is an autoimmune neurologic disease that affects the post synaptic portion of the neuromuscular junction. Usually MG occur in young adults or in the elderly characterized by weakness of fatigue of skeletal muscles due to repetitive use.1-2 It represents a challenge for clinicians due to the diversity of disease manifestations. It is therefore important to monitor the neuromuscular blockade (NMB) due to the multiple presentations of MG. In our case the patient presented with clinical features suggestive of Guillen Barre Syndrome (GBS) which is an autoimmune disease against myelin nerve sheath. Initially he was planned to be treated as GBS because of it’s unusual descending paralysis like presentation. Nerve conduction studies were done a few times and were found to be normal. Anti acetylcholine receptor antibody test was found positive. Plane X Ray of chest and CT scan of Chest showed a mediastinal mass suggestive of Thymoma. Patient recovered dramatically after receiving treatment for Myasthenia Gravis. Bangladesh Crit Care J March 2018; 6(1): 54-56