• 1 Hospital Segamat


Myasthenia gravis, the most common autoimmune
neuromuscular disorder, is characterised by
muscle weakness and fatigability. A 23-yearold-lady
with background history of breathing
and swallowing difficulty for six months was
presented with respiratory distress to the hospital
which is without an in-house neurology service.
Her diagnosis remained a challenge as patient
presented as an emergency without detailed
medical history. She was subjected to bedside ice
pack testing and subsequently managed along the
diagnosis of myasthenia crisis. She responded to
the treatment and survived the critical period. So,
diagnosis of myasthenia gravis by ice pack test
and managing a case of myasthenic crisis would
be possible in limited heath care setting.