Eleven-Year-Old Male With Weakness

A previously healthy 11-year-old boy presented to the emergency department with 3 weeks of progressive muscle weakness. He initially had weakness and fatigability of the lower extremities. He then developed left eye ptosis, slurring of his words, and difficulty chewing. Laboratory results obtained by his pediatrician, including those for CBC count, creatine phosphokinase level, erythrocyte sedimentation rate, and thyroid studies, were unremarkable. He denied fever, weight loss, or rash. On physical examination, his muscles had normal bulk; however, he had generalized hypotonia and weakness, with proximal muscles affected more than distal ones.

https://ift.tt/2uMn5vk