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Myasthenia Gravis Misdiagnosed as Post-Thyroidectomy Recurrent Laryngeal Nerve Palsy: A Case Report

Authors:

R. Sripriya,

Mahatma Gandhi Medical College and Research Institute, Puducherry, IN
About R.
Professor, Department of Anaesthesiology
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Reesha Joshi ,

Saveetha Medical College & Hospital, Tamil Nadu, IN
About Reesha
Assistant Professor, Department of Anaesthesiology
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T. Sivashanmugam,

Mahatma Gandhi Medical College and Research Institute, Puducherry, IN
About T.
Professor, Department of Anaesthesiology
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M. Ravishankar

Mahatma Gandhi Medical College and Research Institute, Puducherry, IN
About M.
Professor, Department of Anaesthesiology
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Abstract

About 85% of patients with myasthenia gravis present with ptosis and generalised muscle weakness, but 15% may present with pure bulbar symptoms which can be misdiagnosed. We describe a 60-year old female patient with multinodular goitre who had symptom of dysphagia and was subjected to total thyroidectomy. Post-operatively she developed respiratory distress and had difficulty in phonation. Bilateral vocal cord palsy was identified and emergency tracheostomy was done. Review of the patient revealed a mass in the anterior mediastinum and the patient showed improvement with pyridostigmine. Thymoma was confirmed in the computed tomography scan. This case highlights the unanticipated problems faced due to an undiagnosed myasthenia gravis and the importance of having a high index of suspicion of myasthenia gravis in patients with subtle bulbar symptoms.
How to Cite: Sripriya, R., Joshi, R., Sivashanmugam, T. and Ravishankar, M., 2021. Myasthenia Gravis Misdiagnosed as Post-Thyroidectomy Recurrent Laryngeal Nerve Palsy: A Case Report. Sri Lankan Journal of Anaesthesiology, 29(1), pp.68–70. DOI: http://doi.org/10.4038/slja.v29i1.8680
Published on 28 Apr 2021.
Peer Reviewed

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