Juvenile Myasthenia Gravis: Musk Positive: with 3 Cardinal signs

Anti muscle specific tyrosine kinase (Musk) antibody is the most common antibody identified in seronegative myasthenia gravis (SNMG). Juvenile onset musk myasthenia has different clinical course as demonstrated in our case with spontaneous remission followed by resurgence of symptoms with ocular complaints. Musk myasthenia characteristically presents with bulbar and respiratory muscle involvement with a high rate of myasthenic crisis. Early identification is necessary to decrease the incidence of myasthenic crisis. We report a atypical case of musk myasthenia gravis with 3 cardinal signs which responded completely to immunosuppressants.