DOI: 10.36347/sjmcr.2014.v02i11.007

Pages: 720-722

Myasthenia gravis is an autoimmune disease in which autoantibodies mediate damage and destruction of acetylcholine receptors in striated muscle causing impairment of neuromuscular coordination. It causes weakness and fatiguability of skeletal musculature sparing cardiac involuntary muscles. It occurs in three forms ocular, bulbar and generalized. Two thirds of ocular myasthenia presents as diplopia and ptosis, but isolated ptosis and isolated diplopia in 10% and 30% respectively. This case presented with isolated uniocular ptosis of right eye with retraction of contralateral upper eye lid. Investigations like ice pack test, fatigue test, neostigmine test and serological tests like acetylcholine autoreceptor antibodies showed positive results. Patient was treated with oral corticosteroid but on maintenance dose symptoms recurred. Tab Pyridostigmine 60mg qid was combined with maintenance dose of corticosteroids showed steroid related complications in a period of 1 month. Patient recovered with immunosuppressant Tab Azathioprine 50mg OD showing neither of the steroid related complications.