title: Autoimmune myasthenia gravis after sternal fracture.
abstract: We report a 54-year-old woman who suffered a commotio cerebri, whiplash injury and a chest trauma with sternal fracture due to a high-velocity car accident. Two months later, she developed unilateral ptosis and blurred vision, which worsened during the day. Multiple diagnoses were suggested, ranging from thoracic outlet syndrome towards depression. Symptoms persisted and five years later, the patient consulted a neurologist. Laboratory analysis revealed significantly elevated levels of antibodies to acetylcholine receptors, and the diagnosis of myasthenia gravis was made. Speculatively, the damage of retrosternal thymic remnants due to a sternal fracture might have precipitated the condition or exacerbated subclinical disease.
authors.affiliation: Department of Neurology, University Hospital Zurich, Zurich, Switzerland.
authors.forename: Jens A
authors.initials: JA
authors.lastname: Petersen
authors.forename: Hans H
authors.initials: HH
authors.lastname: Jung
authors.forename: Michael
authors.initials: M
authors.lastname: Weller
authors.forename: Michael
authors.initials: M
authors.lastname: Linnebank