Abstract：
Myasthenia gravis (MG) is an acquired autoimmune disease. Its clinical manifestations comprise ptosis, diplopia, dysarthria, dysphagia, limb weakness, and in severe cases, respiratory muscle involvement. Dysarthria as an exclusive initial and primary complaint in MG is rare and seldom reported. In this paper, we report a case of type IIIb MG with isolated dysarthria as the only clinical manifestation and we review the relevant literature. The patient was a 62-year-old man who presented with episodes of slurred speech for 20 days that had worsened in the previous 9 days. His medical history comprised hypertension, diabetes mellitus, and coronary heart disease. The initial diagnosis on admission was transient ischemic attack. Careful re-examination of the patient\'s history revealed that his symptoms mainly involved increasingly worse slurred speech episodes without drinking or swallowing difficulties, and no significant improvement with rest was observed. Electromyography and autoantibody profiling led to a diagnosis of type IIIb MG. His symptoms improved after the oral administration of pyridostigmine bromide 60 mg. Laryngeal MG is important to differentiate from stroke. It is necessary to perform a computerized voice analysis when encountering patients with atypical symptoms of MG.
摘要：
重症肌无力(MG)是一种获得性自身免疫性疾病。其临床表现包括上睑下垂，复视,构音障碍,吞咽困难,四肢无力,在严重的情况下，呼吸肌受累。构音障碍作为MG的唯一初始和主要主诉很少见，也很少报道。在本文中,我们报告一例以孤立构音障碍为唯一临床表现的IIIb型MG，并复习相关文献。该患者是一名62岁的男子，他出现了长达20天的言语不清的发作，在过去的9天中恶化了。他的病史包括高血压，糖尿病,和冠心病。入院时最初诊断为短暂性脑缺血发作。仔细重新检查患者的病史显示，他的症状主要包括越来越严重的言语不清，没有饮酒或吞咽困难，休息时未观察到显着改善。肌电图和自身抗体谱分析导致IIIb型MG的诊断。口服溴吡啶斯的明60mg后，他的症状有所改善。喉部MG对鉴别中风有重要意义。遇到MG症状不典型的患者时，有必要进行计算机语音分析。
