What is a hallmark of myasthenic crisis?

• A. Seizures
• B. Hypertension
• C. Severe muscle weakness with respiratory failure
• D. Skin rash

Answer: (C)

An acute, life-threatening worsening of muscle strength that includes the muscles used for breathing, leading to respiratory failure, is the hallmark of a myasthenic crisis. In myasthenia gravis, weakness worsens with activity, and when the diaphragm and intercostal muscles become severely weak, ventilation can fail. This emergency status distinguishes a crisis from the usual fatigable weakness seen with MG. Triggers such as infection, surgery, or certain medications can precipitate it, so quick recognition is crucial. Management focuses on securing the airway and rapidly reducing circulating antibodies, typically with plasmapheresis or IVIG, while adjusting neuromuscular therapies and providing supportive care.