An interesting cause of dysphagia in a patient with parkinson’s disease

Abstract

Parkinson’s disease is a neurodegenerative disorder and dysphagia is a frequent symptom of Parkinson’s 
disease. We report a case of 61 year old male who presented with history of dysphagia, dysarthria, and 
diplopia of 6 weeks duration. He was a known case of Parkinson’s disease for the past one year and was on 
levodopa. On examination he had bilateral ptosis and jaw weakness. Neostigmine test and acetylcholine 
receptor antibodies were positive. Repetitive nerve stimulation test was positive for decremental response. 
Hence diagnosis of myasthenia gravis was made. Dysphagia is a common manifestation of advanced 
parkinson’s disease. But in patients in whom dysphagia does not improve with levodopa, one should keep 
possibilities of other etiologies for dysphagia in their mind and work up should be done to rule out other 
etiologies. We report this case to highlight a rare occurrence of Parkinson’s disease with myasthenia gravis