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BMJ Case Rep ; 13(12)2020 Dec 17.
Article in English | MEDLINE | ID: mdl-33334740

ABSTRACT

Myasthenia gravis (MG) is a rare and potentially dangerous autoimmune condition, which affects the acetylcholine receptors at the neuromuscular junction of skeletal muscle. MG's diverse symptomatology may readily masquerade as other neurological conditions, posing a diagnostic challenge to clinicians. We describe a 24-year old man who presented to the emergency department with a new onset internuclear ophthalmoplegia. After a series of investigations, we eventually arrived at a diagnosis of MG with pseudointernuclear ophthalmoplegia with an incidentally detected prolactinoma. We explore the literature regarding the pathophysiology of pseudointernuclear ophthalmoplegia, the link between prolactin and autoimmunity and the association between prolactinoma and MG.


Subject(s)
Diplopia/etiology , Myasthenia Gravis/diagnosis , Ocular Motility Disorders/etiology , Pituitary Neoplasms/diagnosis , Prolactinoma/diagnosis , Humans , Incidental Findings , Male , Myasthenia Gravis/complications , Myasthenia Gravis/immunology , Ocular Motility Disorders/diagnosis , Pituitary Gland/diagnostic imaging , Pituitary Gland/metabolism , Pituitary Neoplasms/blood , Pituitary Neoplasms/complications , Prolactin/blood , Prolactin/metabolism , Prolactinoma/blood , Prolactinoma/complications , Tomography, X-Ray Computed , Young Adult
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