Myasthenia Gravis — RACP Paediatrics MCQ

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ModerateNeurology & DevelopmentMyasthenia GravisRACP Paediatrics

A 5-year-old girl presents with ptosis that worsens through the day, diplopia, and fatigable proximal weakness. Acetylcholine receptor antibodies are positive. Tensilon (edrophonium) test is positive. What is the diagnosis?

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Correct answer: D — Myasthenia gravis

Juvenile myasthenia gravis presents with fatigable weakness, ptosis, ophthalmoplegia, and bulbar symptoms. AChR antibodies are positive in ~80%. Diagnosis confirmed by edrophonium test or repetitive nerve stimulation. Treatment includes pyridostigmine, immunosuppression (prednisolone, azathioprine), and thymectomy if thymoma or refractory disease.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Myasthenia Gravis