Chief Complaint:

Chief Complaint

A 23-year-old woman presents with complaints of muscle weakness in the face.

History:

The patient is a 23-year-old administrative assistant who complains of intermittent muscle weakness in her face that has been getting worse over the past 3 months. She also states that as she chews, her jaws feel tired. Swallowing has also become difficult. She reports episodes of double vision (diplopia), which seems to occur after reading for a few minutes in the late evening. With certain strenuous activities or after typing for long periods of time at work, she reports problems with bilateral arm weakness.

Physical Examination:

Notable ptosis (drooping) of the eyelids after repeated blinking exercises. When asked to smile, she appears to be snarling. Reflexes and sensation are normal in both upper and lower extremities. There is considerable weakness of the arms noted bilaterally after exercise.

Case Questions:

1. Is the patient’s condition neurological, musculoskeletal, or both? Explain why and support your thoughts with evidence-based literature. What would be a possible neurologic or musculoskeletal condition causing the symptoms?

2.Explain the pathophysiology behind the condition.

3.What pharmacological agent(s) are commonly used to treat the disorder and how do the agent(s) alter the pathophysiology of the condition?

4.What would be your educational plan for the patient?

 

 

 

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