MYASTHENIA-GRAVIS PRESENTING AS RESPIRATORY-FAILURE - 3 CASES

Background. Myasthenia gravis is usually revealed by a ptosis or a dip lopia. A respiratory muscle weakness often occurs during the course bu r an acute respiratory failure as initial feature is unusual. Case rep orts. - Three girls, aged 8, 10 and 14 years, were hospitalised in an intensive care unit, along a 15 year-period for an acute respiratory d istress. The first two children suffered from skeletal and bulbar musc le weakness. The third, admitted with the diagnosis of unexplained pne umonia was complaining of skeletal and bulbar muscle weakness for the last 18 months. Myasthenia gravis was confirmed with electromyography, and detection of the acetylcholine-receptors antibodies in all three cases. Conclusion. - Any unexplained acute respiratory distress must l ead to search for skeletal and bulbar muscle weakness, specially after muscular exercise or at the end of day, manifestations which characte rize myasthenia gravis.