Distinguishing Myasthenia Exacerbation from Severe Preeclampsia: A Diagnostic and Therapeutic Challenge
Published: August 1, 2015 | DOI: https://doi.org/10.7860/JCDR/2015/.6357
Pooja Sikka, Bharti Joshi, Neelam Aggarwal, Vanita Suri, Hement Bhagat
1. Assistant Professor, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
2. Research Officer, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
3. Associate Professor, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
4. Professor, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
5. Associate Professor, Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India.
Correspondence
Dr Bharti Joshi,
House No 506, Sec 15 A, Chandigarh, India.
E-mail: drbhartijoshi09@gmail.com
Myasthenia gravis is an acquired, autoimmune neuromuscular disorder characterized by voluntary muscle weakness. Pregnant patients may have disease exacerbation, respiratory failure, crisis, adverse drug reaction, surprisingly enough remission at any trimester or postnatal period. Concurrence of myasthenia gravis with severe preeclampsia is a dreadful condition raising diagnostic and management issues. We hereby discuss a case of myasthenic woman who developed severe preeclampsia during pregnancy and presented in last trimester with clinical features mimicking signs of impending eclampsia. Keeping in mind the history of myasthenia gravis, urgent neurology review taken and diagnosis of myasthenic exacerbation was entertained. She responded well to injection neostigmine and in this way inadvertent use of magnesium sulphate was avoided.
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