Diltiazem Exacerbated Myasthenia Gravis

Although this patient’s symptoms mimicked those he had experienced
10 years earlier, it was difficult for clinicians to identify the cause.

Myasthenia gravis (MG) is an autoimmune disorder characterized by involuntary muscle weakness and fatigue. It usually begins with the extraocular muscles and eventually descends to bulbar muscles involving the jaw, neck, proximal limbs, and respiratory muscles. The most common symptoms include ptosis, dyspnea, dysarthria, diplopia, and difficulty speaking or swallowing.¹ Although the exact mechanism of MG is not fully understood, the role of antibody-mediated pathogenesis at the neuromuscular junction level has been well-established.