Intermittent Weakness and Mediastinal Weakening

INTRODUCTION The association of myasthenia gravis (MG) with thymoma is about 15%, which increases to about 35% in older patients (1,19). Thymomas represent nearly 50% of tumors in the anterior mediastinum and if large enough may cause mediastinal widening (12). The connection between the thymus gland and MG has led to the medical recommendation of a thymectomy, however, a thymectomy does not cure MG but may significantly decrease the symptoms in 90% of patients with MG (13). If a female between the ages of 20-30 or a male older than 60 complains of generalized fatigue, eye muscle weakness, dysphagia, dystonia, and/or dysarthria MG should be considered and thymoma ruled out (1, 3, 4). This case report provides detailed descriptions and illustrations of how to recognize and treat MG, the importance of investigating for a thymoma, and current information regarding a thymectomy. Overall, even though evidence has shown the correlation between MG with thymoma, this case report depicts how a patient may present with multiple complaints yet specific to the diagnoses illustrating the importance of conducting a thorough history and physical.