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Suggest Treatment For Swallowing Difficulty While On Treatment For Myasthenia Gravis

Posted on Tue, 2 Feb 2016

Question: I have myasthenia gravis although feel I have been in 'remission' for some time so have not had mestinon for about four years. Recently, I have had a feeling of something stuck in my throat and even water sometimes feels like it has lumps in it. The other main problem I have at the moment is that my skin is very very itchy, no rash, although becomes rash looking from my scratching. It keeps me awake at night and I feel I could rip my arms and legs off. I have recently weaned myself off HRT. Its driving me crazy.

Answered by Dr. Ajay Panwar (3 hours later)

Brief Answer:
Swallowing difficulty may be due to myasthenia gravis.

Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.

Some patients can have isolated swallowing difficulty in myasthenia.I would like to know the following details-
1)Which muscles were primarily involved with your myasthenia gravis illness?Restricted to speech,swallowing,extraocular or generalized?
2)Since when you are having this 'something stuck in my throat' problem?Is it of fluctuating course as the symptoms typically are in myasthenia?

However,itching and rash don't appear to be related to the illness.

Please follow up with details so that I can answer this well.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Ajay Panwar (1 hour later)

Originally muscles in legs arms and body in general. Had droopy eye, felt like I was losing my voice sometimes. At the time I was working very hard, 12to 16 hour days, 7 days a week, on my feet. Over the past 7 years, although still working hard, it is not so intense.
It is just over the last 3 months that I have had the throat thing, although about a year ago had the same problem and could not eat much, lost weight. At the moment I still eat, watch what I eat.

Answered by Dr. Ajay Panwar (37 minutes later)

Brief Answer:
Trial of mestinon is warranted.

Detailed Answer:
Hi XXXX,
Thanks for being in follow-up and providing further details.

Considering your clinical details, a trial of mestinon appears warranted because these symptoms can be a part of your myasthenia.So, start mestinon and observe if the symptoms improve.

If you have some further questions,I shall be glad to have you in follow-up.

Regards
Dr.Ajay Panwar,
MD,DM(Neurology)

Note: Hope the answers resolves your concerns, however for further guidance of skin related queries consult our Dermatologist.Click here to book a consultation

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar