Seronegative Myasthenia Gravis Presenting as Dysphagia in a Young Male- A Diagnostic Dilemma

21year old gentleman presented with insidious onset, gradually progressive dysphagia for 2 weeks. There was no other associated signs or symptoms. Initial blood workup, radiological investigations and diagnostic interventions were non-contributory. In the meantime, worsened found to be advancement of day. Oesophageal manometric studies showed gradual weakening peristaltic contractions after a string repetitive swallows. Repetitive nerve stimulation test edrophonium suggestive Myasthenia Gravis; Anti-acetylcholine receptor antibody anti-MuSK negative. He initiated on Pyridostigmine had improvement few days. has now achieved remission. Hence, we present curious case Seronegative Gravis in young who only recovered Pyridostigmine.