Myasthenia gravis: An important differential diagnosis when assessing a patient with ent symptomatology

Abstract

Myasthenia gravis is an autoimmune disease of the neuromuscular junction, charac- terized by the presence of autoantibodies directed against the postsynaptic membrane receptors, blocking neuromuscular transmission in skeletal striated muscles, leading to a decrease in the number of receptors at the motor neuroplate. Clinically, myasthenia gravis presents as focalized or generalized muscle weakness. For the ENT the most fre- quent presentation is the bulbar involvement which presents as dysphonia, dysphagia, weakness of facial musculature or a combination of all. We report 2 cases of patients with completely different manifestations of the same disease. The first case is a patient with mild bulbar musculature compromise and the other, is a patient with severe generalized myasthenia who had to be admitted to the ICU for a myasthenic crisis.