Table 1

Clinical details of the patients

	Patient 1	Patient 2	Patient 3
Anti-AChR, anti-cholinergic receptor antibodies; CT, computed tomography; EMG, electromyography; MCD, mean difference between consecutive discharges; MG, myasthenia gravis; ND, not done; SF-EMG, single fibre electromyography; UES, upper oesophageal sphincter.
Age (years)	28	25	28
Sex	Female	Male	Female
Date of diagnosis	October 2000	May 2001	December 2001
Approximate time until diagnosis	4 months	24 months	12 months
Grade of dysphagia	Need for nasogastric tube; aspiration pneumonia	Solids	Solids and liquids
Weight loss	Severe	None	Moderate
Oesophageal fluoroscopy	Contrast passage to airway	Normal	ND
Endoscopy	Acute lesions of gastric mucosa	ND	Normal
Oesophageal manometry	ND	Peristaltic contractions of low amplitude; frequent simultaneous contractions	Reduced UES pressure; peristaltic contractions of low amplitude
Conventional EMG	Normal	Normal	ND
2 Hz Repetitive stimulation	Normal in right abductor digiti minimi, right trapesius, and right nasalis	Normal in right abductor digiti minimi, right trapesius, and right nasalis	Normal in left nasalis
Stimulated SF-EMG	Mean MCD = 78 µs; 10 of 19 fibres with an increased MCD, three with blocking	Mean MCD = 26.3 µs; 10 of 37 fibres with an increased MCD, two with blocking	Mean MCD = 23.4 µs; 3 of 34 fibres with an increased MCD, two with blocking
Anti-AChR antibodies	Negative	Negative	Positive (5.7 nmol/l)
Thyroid hormones	Normal	Normal	Normal
Thoracic CT	2 cm diameter mass in the thymus compartment of doubtful nature	Normal	Normal
Edrophonium test	Absence of a clinically appreciable response	Absence of a clinically appreciable response but transient increase in amplitude of oesophageal peristaltic contractions	Equivocal response during the manometric study
Treatment	Pyridostigmine, plasma exchange (two courses), and prednisone (90 mg daily)	Pyridostigmine	Pyridostigmine
Date at last follow up	March 2004	April 2004	April 2004
Status at last follow up	Neither dysphagia nor other symptoms attributable to MG; right residual hemiparesis but able to walk	Decrease in speed of eating; occasional difficulties with foods of high consistency; no other symptoms attributable to MG	Decrease of speed of eating; frequent difficulties with foods of high consistency; no other symptoms attributable to MG
Treatment at last follow up	Prednisone (20 mg every other day) and pyridostigmine (240 mg daily)	Pyridostigmine (180 mg daily)	Pyridostigmine (240 mg daily)