Myasthenia gravis associated with reduced masticatory function.

This paper describes a case of myasthenia gravis in a 38-year-old woman who first consulted a dentist and then an oral surgeon because of chewing difficulty. Although myasthenia gravis commonly presents with diplopia, ptosis, or both as initial symptoms, chewing difficulty is rare. The patient was given steroid therapy and underwent thymectomy. Changes in bite force were monitored during treatment. The bite force was low when a high titer of anti-acetylcholine receptor antibody (11.0 nmol/l, normal <0.2) was found in the blood, but increased after the titer had decreased (1.5 nmol/l) in response to therapy.