Challenges in Diagnosis and Management of Myasthenic Crisis in Resource Limited Health Care Setting

Abstract

A 23 years old lady with background history of breathing and swallowing difficulty for six months presented with respiratory distress to a district hospital without an in-house neurology service. Her diagnosis remained a challenge as patient presented in severe clinical state without a proper medical history available. She was subjected to bedside ice pack testing and subsequently managed along the diagnosis of myasthenia crisis. To our delight and surprise, she responded to the treatment and survived the critical period. The main purpose of this study is to emphasize the importance of bedside ice pack test in diagnosis of myasthenia gravis in resource limited health setting.