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Myasthenic crisis — RCPSC EM MCQ

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HardNeurological emergenciesMyasthenic crisisRCPSC EM

A 64-year-old woman with myasthenia gravis presents with dyspnoea and dysphagia after pneumonia. Respiratory rate is 28/min, single-breath count is 8, negative inspiratory force is -14 cmH2O, and forced vital capacity is 11 mL/kg. What is the most appropriate disposition?

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Correct answer: D — ICU admission for impending respiratory failure and disease-specific therapy

Low vital capacity, weak negative inspiratory force, dysphagia, and infection trigger indicate myasthenic crisis. ICU-level monitoring and treatment such as IVIG or plasma exchange are required.

Reference: Canadian neuromuscular emergency practice; critical care guidance