title: Differential diagnosis of hallucinations in a patient with myasthenia gravis.
abstract: We present the case of a 63-year-old woman with comorbidity of myasthenia gravis and psychosis. Different diagnostic hypotheses based on a review of the literature are discussed. A protracted history of physical spousal abuse, patient symptoms, and results of different investigations allowed us to conclude that the patient had a form of posttraumatic stress disorder with secondary psychotic features. Psychosis due to myasthenia gravis is rarely seen, and it remains unclear what is the pathophysiology, if any, for such an association. The present case highlights the difficulties the physician faces in disentangling psychosis as a potential manifestation of myasthenia gravis itself versus being caused by a medical side effect of treatment, or psychosis due to a distinct co-occurring neurologic or psychiatric condition.
authors.affiliation: Dr. Ouanes is from the Service de Neurologie, CHU Razi, La Manouba 2010 in Tunisia. Drs. Hizem, Djebara, Kacem, Gargouri, and Gouider are from the Service de Neurologie, CHU Razi, La Manouba 2010 and the Unité de Recherche de Neurophysiologie Clinique et Électrodiagnostic 03/UR/08-09 Faculté de Médecine de Tunis in Tunisia.
authors.forename: Sami
authors.initials: S
authors.lastname: Ouanes
authors.forename: Yosr
authors.initials: Y
authors.lastname: Hizem
authors.forename: Mouna
authors.initials: M
authors.lastname: Ben Djebara
authors.forename: Imen
authors.initials: I
authors.lastname: Kacem
authors.forename: Amina
authors.initials: A
authors.lastname: Gargouri
authors.forename: Riadh
authors.initials: R
authors.lastname: Gouider
keywords: Myasthenia gravis; hallucinations; posttraumatic stress disorder; psychosis