Sudden dysphagia in an elderly, quadriparetic patient.

CLINICAL CASE: We report the case of a 92-year-old quadriparetic patient who suddenly presented a major swallowing disorder following trauma to the neck. A diagnosis of myasthenia gravis was suggested by single-fibre EMG of the extensor digitorum communis muscle. In view of the continued absence of dysphagia after 6 months of pyridostigmine treatment, this diagnosis was considered as definitive.

DISCUSSION: We review the various characteristics of myasthenia gravis and ways of investigating dysphagia.

CONCLUSION

It is important to be aware of and investigate all the direct and indirect signs of dysphagia and establish the exact aetiology in order to provide the best possible treatment.