A 26-year-old female gymnastics instructor presented with occasional facial muscle weakness, from which she had been suffering for the last two months. She complained that she had difficulty swallowing and that her jaws got tired while eating. While reading, particularly in the evening, she also experienced double vision. During her gymnastics sessions, she experienced difficulty due to weakness in her arms. Notable ptosis of both her eyelids was observed during blinking, and she snarled while smiling.
A decrease in the amplitude of contraction of her distal arm muscles and progressive weakness were observed during electromyographic testing. Her symptoms and the results of the electromyographic tests could be reversed with the intravenous administration of edrophonium. Blood testing also showed an elevated level of anti-acetylcholine receptor antibody. What could be the probable…
