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mg or ms?

1K views 8 replies 6 participants last post by  XpaezX 
#1 ·
37 year old women c/o recurrent episodes of double vision,drooping of eyelid..occurs without apparent reason,lasts for hours n resolve spontaneously,occasional hoarseness n difficulty swallowing.
what is the most likely diagnosis?

a) multiple sclerosis
b) myasthenia gravis.
 
#4 ·
episodes lasts for hours n then resolve spontaneously..sounds more like relapsing remitting course of ms..
shouldn't mg have progressive worsening of symptoms with further use?
drooping does point to mg but history according to me supports the dx of ms.
still confused!!
 
#7 ·
MCdonald criteria have low sensitivityand specificty and they are used for confirmation, you can have a clean MRI and lumbar puncture and still diagnose MS if it has classic symptoms,besides they focus more on diagnostic studies (MRI and pattern of dissemination) + frequency of attacks.

This is more MG though, and a really bad one because she is having bulbar symptoms, the double vision is secondary to orbital muscles weakness.
The weird part is that it comes in waves , instead of having the characteristic progressive decline in muscular function.
 
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