[47F] Experiencing transient neurological symptoms post-thymectomy

Patient Description

A 47-year-old female reports transient bilateral eyelid drooping, difficulty swallowing solid food, and slurred speech that worsens with fatigue and cold exposure. These symptoms have been occurring over the last four days. The patient has a history of breast cancer treated with surgery, chemotherapy, radiation, and currently managed with Tamoxifen and tri-weekly immunotherapy (Kanjinti). She underwent a thymectomy last year and has not had any signs of myasthenia gravis prior to the thymectomy. The patient suspects that the immunotherapy may have induced myasthenia gravis. No known drug allergies. No other medications reported.

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Arora's Assessment

What might be happening

Based on your symptoms and medical history, the following conditions may be considered:

  • Myasthenia Gravis: This is a chronic autoimmune neuromuscular disease that causes weakness in the skeletal muscles, which are responsible for breathing and moving parts of the body, including the arms and legs. The hallmark of myasthenia gravis is muscle weakness that increases during periods of activity and improves after periods of rest. Certain muscles such as those that control eye and eyelid movement, facial expression, chewing, talking, and swallowing are often, but not always, involved in the disorder. The onset of the disorder may be sudden, and symptoms often are not immediately recognized as myasthenia gravis. In most cases, the first noticeable symptom is weakness of the eye muscles. In others, difficulty in swallowing and slurred speech may be the first signs.

  • Medication Side Effects: Some medications, including those used for immunotherapy, can cause side effects that mimic the symptoms of myasthenia gravis. It's possible that your symptoms are a side effect of your current medications.

What you can do

You should reach out to your healthcare provider to discuss your symptoms as soon as possible. They may want to adjust your medications or perform additional tests to confirm a diagnosis.

What you should look out for

If you experience any of the following symptoms, seek medical attention immediately:

  • Difficulty breathing
  • Difficulty swallowing to the point where you're unable to eat or drink
  • Slurred speech to the point where you're unable to communicate effectively
  • Weakness in your arms or legs

Please remember that while I strive to provide accurate and helpful health information, this advice is intended to be general in nature, and specific causes may not apply to your situation. Always consult with a healthcare provider for appropriate examinations, treatment, testing, and care recommendations.

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People Also Ask


What are the common symptoms of myasthenia gravis?

Common symptoms of myasthenia gravis include muscle weakness that worsens with activity and improves with rest, drooping eyelids, difficulty swallowing, slurred speech, and weakness in the arms and legs.


Can immunotherapy cause symptoms similar to myasthenia gravis?

Yes, some immunotherapy medications can cause side effects that mimic the symptoms of myasthenia gravis, such as muscle weakness and fatigue.


What should I do if I suspect my medication is causing side effects?

If you suspect your medication is causing side effects, you should contact your healthcare provider to discuss your symptoms. They may adjust your medication or perform tests to determine the cause.


How is myasthenia gravis diagnosed?

Myasthenia gravis is typically diagnosed through a combination of clinical evaluation, blood tests for antibodies, electromyography (EMG), and sometimes imaging studies like a CT scan to check for thymus abnormalities.


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