Dr. Divya Katta

Dr.Mahathi Vankireddi

Abstract

Introduction: Myasthenia gravis is a disease that affects the neuro-muscular junction resulting in muscle weakness and fatiguability. Disease onset prior to 19 years of age is considered Pediatric myasthenia. It is rare with an incidence of 0.35 per 100,000 over a 50-year period.
Case report: a 5-year-old female child was brought with ptosis of 4 months duration, increasing severity as the day progresses and improvement after sleeping as reported by her mother. On examination, she had ptosis in both eyes. The Child has exotropia in left eye with movement restriction inconsistent with any known paretic or restrictive etiology.
She was seronegative for Acetylcholinesterase receptor antibodies and anti-MUSK antibodies. Repetitive nerve stimulation showed no significant differential response at rest and after exercise.
A diagnosis of Seronegative Pediatric ocular myasthenia was made and a neurological consultation for a neostigmine test and muscle biopsy was discussed with the mother.