Myasthenia Gravis is an autoimmune disease that affects neuromuscular junction. It usually presents with weakness of proximal muscles and has predilection for extraocular and bulbar muscles. Chiari I malformation can sometimes mimicsero negative myasthenia gravis. But here we present a case with an unusual association with both Chiari malformation and antibody positive myasthenia gravis occurring in the same patient. The patient also had cervical spondylosis and thymoma. Myasthenia gravis was serologically proven and Magnetic resonance imaging confirmed syringomyelia and ectopic cerebellar tonsils. Such an association has not so far been reported in literature.

Keywords: Myasthenia gravis, Chiari malformation, Syringomyelia.

1. Chaudhuri A, Behan PO. Myasthenic crisis. QJM Int J Med. 2009 Feb 1;102(2):97–107.
2. Muthusamy P, Matte G, Kosmorsky G, R Chémali K. Chiari Type I Malformation A Mimicker of Myasthenia Gravis. The neurologist. 2011 Mar 1;17:86–8.
3. Kolli S, Mathew KM, Thumbikat P, McClelland MR, Nair KPS. Superimposed myasthenia gravis in chronic spinal cord injury: a case report. Spinal Cord. 2011 Dec;49(12):1206–7.
4. Lin C-S, Wang J-H, Wang Y-H, Pan S-L. Myasthenia gravis with superimposed spinal cord injury: a case report. J Rehabil Med. 2008 Aug;40(8):684–6.
5. Gounden S, Lee B, Mellick R, Rutkowski SB, Middleton JW. Ocular myasthenia gravis in a person with tetraplegia presenting challenges in diagnosis and management. Spinal Cord Ser Cases. 2016 Apr 7;2:15037.
6. Alp H, Sap F, Altin H, Karatas Z, Baysal T, Karaarslan S, et al. Thymoma Associated With Loeys-dietz Syndrome Type I. Marmara Med J [Internet]. 2012 [cited 2018 May 15]; Available from: http://www.marmaramedicaljournal.org/summary_en_doi.php3?doi=10.5472/MMJ.2012.02184.1

Dr Kamalasanan.C.G

Additional Professor, Department of General Medicine

Government Medical College, Calicut, Kerala, India

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