USMLE/PLAB/AMC–Clinical Case Quiz - 15

A 33-year-old female presented to the outpatient department complaining of drooping of both eyelids and difficulty in keeping her head up and speaking. The symptoms usually become worse at the end of the day. She has been feeling drooping of eyelids and blurred vision with varying intensity since last 2 and half years. She is otherwise normal. There is no other significant past medical and surgical history. She is not taking any medicine right now.
On examination:

• Head is in the flexed position: Patient feel difficulty in extending the head.
• Difficulty in speaking.
• Pupil Normal.
• Partial drooping of both eyelids.
• Ocular movement normal.
• The soft palate doesn’t move.
• Upper lower limbs: Normal Motor and sensory function
• Cerebellum: Normal.

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