Author(s)

Assétou Kaya Soukho^1*, Djenebou Traoré¹, Adramé Keita¹, Djibril Sy¹, Guida Landouré², Seybou Hassane Diallo³, Youssouf Fofana⁴, Kaly Keita¹, Mamadou Mallé¹, Ibrahima Amadou Dembélé¹, Drissa Sangaré¹, Mamadou Cissoko¹, Barry Boubacar Sangaré², Mamadou Dembélé¹, Abdel Kader Traoré¹, Hamar Alassane Traoré¹

¹Department of Internal Medicine, Point G University Teaching Hospital, Bamako, Mali.
²Department of Neurology, Point G University Teaching Hospital, Bamako, Mali.
³Department of Neurology, GABRIEL TOURE University Teaching Hospital, Bamako, Mali.
⁴Department of Internal Medicine, Mother-Child Hospital “Luxembourg”, Bamako, Mali.

Introduction: Myasthenia is a rare and disabling autoimmune disease. Few studies were devoted to this pathology. We report a clinical case of myasthenia in the Department of Internal Medicine at the Point G University Teaching Hospital. Observation: This is a 41-year-old patient of Malian origin, a trader with a history of hemorrhoidectomy in 2011 and familial hypertension, was admitted on August 19, 2014, for muscle weakness, dysphonia, and dysphagia. The disease started 1 year before admission at the department with progressive muscle weakness of the upper limbs aggravated by repetitive movements and spreading to the head “drooping head” and inferior limbs, associated with general fatigue, dysphonia and selective dysphagia for solid foods. The diagnosis of myasthenia was maintained based on the clinical signs such as ptosis, bilateral diplopia, and weakness with lower limbs muscle strength rated at 3/5, and confirmed with confirmatory exams; a positive anti-acetylcholine receptor antibody (RIA), the post-synaptic neuromuscular conduction block at ENMG and the positive neostigmine pharmacological test. The patient received Neostigmine (prostagmine) 0.5 mg one ampoule in IM/day and Prednisone at a dosage of 1 mg/kg/day. The evolution was marked by a moderate improvement of the symptomatology afterward the patient was evacuated to Tunisia on family request where he received a course of immunoglobulin 2 g/kg in 2 days. The evolution in Tunisia was favorable. The patient returned in Mali and death occurred after 2 months in a context of respiratory distress. Conclusion: Myasthenia is a rare but serious disease requiring careful management and monitoring to reduce respiratory complications.

Myasthenia, Immunoglobulin, Internal Medicine, Point G Hospital

Soukho, A. , Traoré, D. , Keita, A. , Sy, D. , Landouré, G. , Diallo, S. , Fofana, Y. , Keita, K. , Mallé, M. , Dembélé, I. , Sangaré, D. , Cissoko, M. , Sangaré, B. , Dembélé, M. , Traoré, A. and Traoré, H. (2019) Serious Myasthenia at the Department of Internal Medicine of Point G University Teaching Hospital: A Clinical Case. Neuroscience and Medicine, 10, 207-212. doi: 10.4236/nm.2019.103015.