A Male Patient Presents With Isolated Abducens Nerve Palsy: An Atypical Presentation of Ocular Myasthenia Gravis

TL;DR

A 68-year-old man with isolated abducens nerve palsy was found to have ocular myasthenia gravis, highlighting the need for careful diagnosis in atypical cases.

Contribution

This case report presents an atypical initial manifestation of ocular myasthenia gravis as isolated abducens nerve palsy.

Findings

The patient's isolated abducens nerve palsy was linked to ocular myasthenia gravis.

Thorough clinical assessment is crucial for diagnosing atypical presentations of myasthenia gravis.

Abstract

Myasthenia gravis is an autoimmune disease of the neuromuscular junction caused by autoantibodies directed against the acetylcholine receptors. It presents with skeletal muscle weakness, often initially presenting with ocular symptoms such as ptosis and diplopia. When myasthenia gravis is isolated to only ocular symptoms, it is referred to as ocular myasthenia gravis (OMG). Here, we present an atypical initial presentation of OMG in a 68-year-old male patient presenting with isolated abducens nerve palsy at the initial onset. With this case report, we highlight the importance of a thorough history and clinical assessment necessary for a timely diagnosis of OMG in patients who present with isolated abducens nerve palsy.

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