An unusual initiation of an ocular form of musk-positive myasthenia gravis after magnesium administration: A rare case report

The primary clinical symptom in people with myasthenia gravis is muscle weakness that gets worse with activity and gets better with rest; often, the first symptoms are ocular ones, such as ptosis and double vision. On the other hand, individuals with anti-MuSK may present with unusual symptoms. Nonetheless, it is hypothesized that musk antibodies may be present when there are no antibodies present along with bulbar and respiratory symptoms. A 26-year-old pregnant patient was referred to the neurology department after experiencing tongue enlargement. A neuro ophthalmic assessment revealed ptosis with lateral diplopia in the right eye, bulbar palsy, facial weakness, weakness in the palate and pharyngeal reflex, dizziness, and hearing loss in her right ear. The patient was given magnesium sulfate for two days since pre-eclampsia was suspected; however, this treatment exacerbated the development of symptoms and was discontinued. Her myasthenia gravis symptoms gradually improved after starting medication nonetheless, bilateral weakness in the neck and limb flexion persisted. Following a few days of therapy, there were no indications of diplopia, swallowing was normal, and the muscular weakness was somewhat improved. The pasiont put on drug treatment for myasthenia gravis (predlon 60 mg daily, amioran 50 mg twice daily and mistenon) Treating severe myasthenia gravis patients with a customized approach aims to manage their symptoms and improve their quality of life. Reduce muscle weakness, eradicate circulating antibodies, and suppress the abnormal immunological response. Minimizing side effects while attaining ideal symptom control is the ultimate objective.