Transient myasthenia gravis in an elderly woman
- West London Neurosciences Centre, Charing Cross Hospital, London W6 8RF, UK
- Correspondence to: Dr R J M Lane r.laneimperial.ac.uk
Myasthenia gravis is usually a chronic disorder, although remission rates of 25–30% can be expected with judicious interventions such as thymectomy and immunosuppression in appropriate cases. Spontaneous remission occurs rarely. Oosterhuis found a remission rate of only 1% per annum over 17 years among 180 patients with generalised myasthenia gravis treated with anticholinesterases alone.1 We describe a case of ocular and bulbar myasthenia in which there was complete recovery over a matter of weeks without immunosuppressive agents.
The patient, a 78 year old woman, developed acute, painless left sided ptosis in October 2002, while on holiday abroad. There was no diplopia. She had developed hypothyroidism one year before but was euthyroid on replacement therapy. The ptosis resolved gradually over the next few days. There was no family history of autoimmune diseases. Two weeks later she found she could not chew properly towards the end of a meal. …
