Annals of Indian Academy of Neurology
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Year : 2016  |  Volume : 19  |  Issue : 1  |  Page : 99-101

Reversible man-in-the-barrel syndrome in myasthenia gravis

1 Department of Clinical Neurophysiology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
2 Department of Neurology, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India

Correspondence Address:
Poornima A Shah
Department of Clinical Neurophysiology, 2nd Floor, Jaslok Hospital and Research Centre, 15, Dr. G. Deshmukh Marg, Mumbai - 400 026, Maharashtra
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0972-2327.168639

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Man-in-the-barrel syndrome (MBS) is an uncommon presentation due to bilateral, predominantly proximal muscle weakness that has not been described to be associated with myasthenia gravis. We describe a case of myasthenia gravis presenting as MBS. Additionally, he had significant wasting of the deltoids bilaterally with fibrillations on electromyography (EMG) at rest and brief duration (3-6 ms) bi/triphasic motor unit potentials (MUPs) on submaximal effort apart from a decremental response on repetitive nerve stimulation (RNS) at 2 Hz. While electrophysiology is an important tool in the diagnosis of myasthenia gravis, pathological EMG patterns do not exclude the diagnosis of myasthenia gravis.

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