Bulbar Myasthenia Gravis Superimposed in a Medullary Infarction Diagnosed by a Fiberoptic Endoscopic Evaluation of Swallowing With Simultaneous Tensilon Application

A case study of a 75-year-old man showed the patient had difficulty swallowing that was originally thought to be caused by a stroke he'd had. However, once his brain imaging returned to normal following his stroke, the swallowing did not improve and he was later found to have MG. The patient had no detectable antibodies (i.e. seronegative) and his RNS test was negative. A fiberoptic endoscopic evaluation of swallowing (FEES) (aka a scope was performed with a small camera was inserted to watch the patient while swallowing) with simultaneous Tensilon application showed that the patient's swallowing improved with the use of Tensilon, therefore diagnosing MG. To the author's knowledge, this is the only documented case of a patient being diagnosed with MG using FEES.