Abstract
Covid 19 is a global pandemic. The most striking manifestation of SARS-CoV-2 is atypical pneumonia and respiratory complications. However, various neurological manifestations are now well recognized. About 36% of Covid-19 cases have neurological manifestations with a very wide clinical range, the most common symptoms are dizziness and headache. Cases of stroke, encephalitis, myelitis, Bell's palsy, Guillain-Barré, and myasthenia gravis have also been reported. We report a case of a 61-year-old female patient with onset of symptoms of myasthenia gravis after infecting Covid-19. Six weeks before the onset of the first symptom of myasthenia gravis, she had fever, then she was tested for RT-PCR coronavirus which was positive result. Her Covid-19 condition was treated well. Symptoms of myasthenia gravis include ptosis, difficulty swallowing, and dysarthria. Repetitive nerve stimulation test is positive for orbicularis oculi, Acetylcholine receptor-binding antibody was positive. Patient was treated with IVIG 2g/kg, methylprednisolone and pyridostigmine that showed gradual improvement. Myasthenia gravis is an autoimmune disease caused by autoantibodies that against nicotinic Acetylcholine receptors at the neuromuscular junction. Covid 19 causes a cytokine storm, disrupts immune system function, and can produce specialized antibodies, including antibodies against the neuromuscular junction.
