ABSTRACT
A 46-year old woman from Hlaing Thar Yar Township presented to the medical ward of Insein General Hospital with acute onset of fever, dyspnoea and coma. She had one year history of tiredness and feeling of sticky sensation in the throat while swallowing meals. Tiredness was especially marked in the evenings and after heavy work. The feeling of sticky sensation was felt intermittently but it was more remarkably felt during dinner and after having a heavy meal. On admission, she was cyanosed, respiration was depressed and autonomic disturbances were observed. She was treated in the intensive care unit with assisted ventilation. Upon further investigation along with clinical assessment and nerve conduction studies the diagnosis was confi rmed as generalized myasthenia. This is an example of myasthenia presenting with vague signs and symptoms that fi nally lead to a health crisis. The delay in diagnosis occurred due to lack of detailed analysis of the symptoms, lack of suspicion and the unique presentation of the case with vague symptoms. The lesson to be learnt from this case is that neuromuscular disorders should always be considered in cases presenting with throat problems.