title: Distinguishing Myasthenia Exacerbation from Severe Preeclampsia: A Diagnostic and Therapeutic Challenge.
abstract: 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.
authors.affiliation: Assistant Professor, Department of Obstetrics and Gynaecology, PGIMER , Chandigarh, India .
authors.forename: Pooja
authors.initials: P
authors.lastname: Sikka
authors.affiliation: Research Officer, Department of Obstetrics and Gynaecology, PGIMER , Chandigarh, India .
authors.forename: Bharti
authors.initials: B
authors.lastname: Joshi
authors.affiliation: Associate Professor, Department of Obstetrics and Gynaecology, PGIMER , Chandigarh, India .
authors.forename: Neelam
authors.initials: N
authors.lastname: Aggarwal
authors.affiliation: Professor, Department of Obstetrics and Gynaecology, PGIMER , Chandigarh, India .
authors.forename: Vanita
authors.initials: V
authors.lastname: Suri
authors.affiliation: Associate Professor, Department of Obstetrics and Gynaecology, PGIMER , Chandigarh, India .
authors.forename: Hement
authors.initials: H
authors.lastname: Bhagat
keywords: Inadvertent; Magnesium sulphate; Myasthenia gravis; Neostigmine; Thymectomy