Researchers presented the case of a 62-year-old man with type IIIb myasthenia gravis (MG) whose only clinical symptom was dysarthria. The case report was published in the Journal of International Medical Research.

The report noted that the man presented with slurred speech episodes over a 20-day period that had begun to worsen in the previous 9 days. Electromyography and antibody profiling confirmed the diagnosis of type IIIb MG.

“Dysarthria as an exclusive initial and primary complaint in MG is rare and seldom reported,” the authors wrote.

The authors reported that a man presented to their hospital in June 2021 and was admitted for slurred and slowed speech for the previous 20 days, which had recently worsened. He had no disturbance of consciousness, headache, dizziness, diplopia, or problems with drinking or swallowing. He had a history of diabetes, hypertension, and coronary heart disease.

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The initial diagnosis was a transient ischemic attack, but MG was not ruled out. A fatigue test and a neostigmine test were negative, but autoantibody profile testing for neuromuscular junction disease was positive for acetylcholine receptor antibodies (immunoglobulin G), confirming the presence of type IIIb MG.

The patient was administered 60 mg of pyridostigmine bromide 3 times per day, and his symptoms improved. Two months later, he had continued the treatment and his symptoms had resolved without recurrence.

The authors hope this case will alert clinicians to the possibility of MG in the presence of dysarthria, and they recommend an evaluation of voice quality in patients with this symptom.


Li W, He L, Jin X, Li L, Sun C, Wang C. Isolated dysarthria as the sole manifestation of myasthenia gravis: a case report. J Int Med Res. Published online August 1, 2022. doi:10.1177/03000605221109395