A Rare Cause of Dysphagia: A Case Report

Abstract

Dysphagia is a common clinical symptom for an ENT surgeon in his clinic, evaluation of which may not be a great challenge. The objective of this article is to report a rare cause of dysphagia which may be difficult to diagnose unless specifically thought of. This is a report of a case of dysphagia secondary to myasthenia gravis seen in a young lady along with tongue fasciculation in an early onset case unlike the ones reported in the literature where the patients are elderly and more often males in the late phase of the disease. At times, dysphagia may be seen secondary to some rare causes and may mislead the doctor. A carefully taken history and methodical clinical examination will avoid unnecessary invasive procedures and delay in the diagnosis.

Predominant Intractable Nausea in the Diagnosis of Bulbar Myasthenia Gravis: A Case Study and Review of Literature

“…However, this is seen as a classic presentation of small bowel obstruction, rather than an initial manifestation of MG [ 7 ]. One plausible explanation is the development of autonomic instability secondary to MG that leads to potential widespread neuropathy [ 8 ]. This can affect the tone of the vagus nerve, causing a pathophysiologic phenomenon similar to gastroparesis.…”

Activation of the Kelch-like ECH-Associated Protein 1 (Keap1)/NF-E2-Related Factor 2 (Nrf2) Pathway through Covalent Modification of the 2-Alkenal Group of Aliphatic Electrophiles in Coriandrum sativum L.

“…The leaves of Coriandrum sativum L. ( C. sativum ), also known as cilantro, Chinese parsley, or paxi, are not only consumed as a spice to add flavor to food but also traditionally used as a medicine for gastrointestinal disorders, pain, inflammation, and oxidative stress. , Although a variety of chemicals have been identified in C. sativum leaves, − the exact nature of the bioactive substances in the leaves that provide relief from such disorders is poorly understood. Lipopolysaccharide-induced inflammation has been suppressed, presumably by rutin in the leaves of C. sativum .…”

Dysphagia as a Presenting Symptom of Myasthenia Gravis—Case Report

“…The Myasthenia Gravis Foundation of America proposed a clinical classification of the disease into five main classes and several subclasses, according to the location of muscle weakness and its intensity. Ptosis or extraocular muscle weakness is the initial presentation in 75% of patients [1] and occurs during the course of the disease in 90% of cases (remaining exclusively ocular only 16% of cases [2][3][4]). Dysphagia is a common symptom in MG and it occurs in 15% -40% [4] of patients with the generalized form of the disease, however, dysphagia as a presenting symptom is rare, occurring in 6% [4] of cases and more rarely as the initial and unique symptom of the disease.…”

“…Ptosis or extraocular muscle weakness is the initial presentation in 75% of patients [1] and occurs during the course of the disease in 90% of cases (remaining exclusively ocular only 16% of cases [2][3][4]). Dysphagia is a common symptom in MG and it occurs in 15% -40% [4] of patients with the generalized form of the disease, however, dysphagia as a presenting symptom is rare, occurring in 6% [4] of cases and more rarely as the initial and unique symptom of the disease. On physical examination, muscle strength should be thoroughly checked in multiple muscle groups to document and assess disease severity and monitor the treatment.…”