title: Rippling muscles and myasthenia gravis with rippling muscles.
abstract: OBJECTIVE
  To describe a patient with rippling muscles and myasthenia gravis.
  
  
  METHODS
  Clinical, laboratory, electrophysiologic, and muscle biopsy data are reported.
  
  
  METHODS
  Medical office and hospital.
  
  
  METHODS
  We describe a patient with rippling muscles (as seen in rippling muscle disease) and myasthenia gravis (MG) with thymoma. There was no family history of rippling muscle disease in our patient. Diplopia and other symptoms of MG were initially overshadowed by the striking rippling phenomenon. The rippling resolved when the MG became florrid.
  
  
  METHODS
  The patient was treated with pyridostigmine, prednisone, and plasmaphereses before removal of a thymoma.
  
  
  RESULTS
  His MG improved with treatment and the rippling has not recurred 4 months after thymectomy.
  
  
  CONCLUSIONS
  Rippling muscle disease is rare and usually inherited. Our patient with rippling muscles (but no family history of rippling muscle disease) and MG suggests that rippling muscles may also be triggered by an autoimmune phenomenon.
authors.affiliation: St. Elizabeth's Medical Center, Youngstown, Ohio, USA.
authors.forename: C F
authors.initials: CF
authors.lastname: Ansevin
authors.forename: D P
authors.initials: DP
authors.lastname: Agamanolis
mesh_terms: D001706:Biopsy; D004594:Electrophysiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology / Q000503:physiopathology*; D009135:Muscular Diseases / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D009157:Myasthenia Gravis / Q000150:complications*; D013945:Thymoma / Q000150:complications; D013953:Thymus Neoplasms / Q000150:complications