A young female exhibits abnormal fatigue of muscles, muscular movements though initially strong, rapidly tire as the day advances. There was ptosis, weakness of chewing, swallowing & speaking. The symptoms showed a remitting course & often were precipitated by emotions, infection & pregnancy. On examination the nervous system was found to be normal. Remarkable recovery was seen after injection of neostigmine intramuscularly.
Q1. What is your diagnosis?
Q2. What is the cause for this condition?
Q3. How does neostigmine improve the condition?
A1. It is Myasthenia gravis.
A2. It is an autoimmune disorder characterized by the
formation of circulating antibodies against the Nicotinic type
Acetylcholine receptors.
A3. Neostigmine is a choline esterase inhibitor, thereby
prevents destruction of acetylcholine at NMJ.