A housewife, aged 27, visited ENT clinic of National Tochigi Hospital complaining of bilateral lagophthalmos. After spontaneous abortion she complained of difficulties with speech and swallowing manifested by hypernasal speech and nasal regurgitation. Muscle weakness increased characteristically as muscle activity continued: that is, there was easy fatigability. The symptoms tend to fluctuate from day to day.
The diagnosis of myasthenia gravis was established by the injection of Tensilon and the results of EMG of masseteric and facial muscles. The x-ray exammination revealed thymic hyperplasia and paralysis of the soft palate.
Treatments used were anticholinesterase drugs such as Vagostigmin, Ubretid, Mestinon, Myterase and ACTH. Tracheotomy and positive pressure ventilation were performed.
Otolaryngologists should remember myasthenia gravis as one of the diseases with bilateral facial palsy.
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