Uncommon Neurological Comorbidity: A Patient with Myasthenia Gravis and Epilepsy. A Case Report

Abstract

Myasthenia gravis (MG) is a rare autoimmune disorder characterized by an antibody-mediated neuromuscular transmission block, leading to skeletal muscle weakness and fatigue. Epilepsy, a condition of unprovoked, recurrent seizures, rarely coexists with MG. Recent studies indicate an elevated epilepsy risk in patients with autoimmune diseases, including MG, potentially linked to autoimmune mechanisms or long-term anticonvulsant use.

We report a 73-year-old woman diagnosed with MG, treated with pyridostigmine, with complaints of difficulty swallowing, excessive salivation, drooping eyelids, increased fatigue in the arms and legs, and with three generalized tonic-clonic (GTC) seizures in the past year, each lasting 1–2 minutes. The most recent seizure occurred a week before hospitalization. Neurological examination revealed bilateral ptosis, increased limb fatigue, and dysphagia. Electromyography (EMG) confirmed postsynaptic neuromuscular damage consistent with MG. electroencephalography (EEG) demonstrated epileptiform activity.

This case highlights the rare but clinically significant coexistence of MG and epilepsy, emphasizing the need for thorough neurological assessment in MG patients with seizure-like episodes. Recognizing epilepsy in MG is crucial for appropriate treatment and improved patient outcomes. Further research is needed on autoimmune comorbidities in neurological disorders.