Syed Wajihullah Shah, Maryam Khalil, Mansoor Iqbal, Arham Arif Kundi, Muhammad Hassaan
{"title":"A Posterior Cranial Fossa Lesion Mimicking Myasthenia Gravis.","authors":"Syed Wajihullah Shah, Maryam Khalil, Mansoor Iqbal, Arham Arif Kundi, Muhammad Hassaan","doi":"10.12890/2024_005032","DOIUrl":null,"url":null,"abstract":"<p><p>A 41-year-old male with prior diagnosis of seronegative myasthenia gravis presented with complaints of bilateral ptosis, dysphagia, nasal voice and nasal regurgitation. Despite treatment with pyridostigmine, there was lack of significant improvement in the symptoms. Further investigations, including antibody assays and nerve conduction studies did not support the diagnosis. Magnetic resonance imaging revealed a lesion in the posterior cranial fossa, consistent with meningioma, which was compressing surrounding structures. This case highlights the importance of imaging techniques and considering alternative diagnosis in patients with unusual presentations to ensure appropriate management.</p><p><strong>Learning points: </strong>This case emphasizes the importance of imaging in patients presenting with symptoms similar to those of neuromuscular junction disorders.It also highlights the possible challenges in diagnosis of such patients.</p>","PeriodicalId":11908,"journal":{"name":"European journal of case reports in internal medicine","volume":"11 12","pages":"005032"},"PeriodicalIF":0.0000,"publicationDate":"2024-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11623349/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"European journal of case reports in internal medicine","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.12890/2024_005032","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/1/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"Medicine","Score":null,"Total":0}
引用次数: 0
Abstract
A 41-year-old male with prior diagnosis of seronegative myasthenia gravis presented with complaints of bilateral ptosis, dysphagia, nasal voice and nasal regurgitation. Despite treatment with pyridostigmine, there was lack of significant improvement in the symptoms. Further investigations, including antibody assays and nerve conduction studies did not support the diagnosis. Magnetic resonance imaging revealed a lesion in the posterior cranial fossa, consistent with meningioma, which was compressing surrounding structures. This case highlights the importance of imaging techniques and considering alternative diagnosis in patients with unusual presentations to ensure appropriate management.
Learning points: This case emphasizes the importance of imaging in patients presenting with symptoms similar to those of neuromuscular junction disorders.It also highlights the possible challenges in diagnosis of such patients.
期刊介绍：
The European Journal of Case Reports in Internal Medicine is an official journal of the European Federation of Internal Medicine (EFIM), representing 35 national societies from 33 European countries. The Journal''s mission is to promote the best medical practice and innovation in the field of acute and general medicine. It also provides a forum for internal medicine doctors where they can share new approaches with the aim of improving diagnostic and clinical skills in this field. EJCRIM welcomes high-quality case reports describing unusual or complex cases that an internist may encounter in everyday practice. The cases should either demonstrate the appropriateness of a diagnostic/therapeutic approach, describe a new procedure or maneuver, or show unusual manifestations of a disease or unexpected reactions. The Journal only accepts and publishes those case reports whose learning points provide new insight and/or contribute to advancing medical knowledge both in terms of diagnostics and therapeutic approaches. Case reports of medical errors, therefore, are also welcome as long as they provide innovative measures on how to prevent them in the current practice (Instructive Errors). The Journal may also consider brief and reasoned reports on issues relevant to the practice of Internal Medicine, as well as Abstracts submitted to the scientific meetings of acknowledged medical societies.
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