In Myasthenià gravis, muscle least likely to be involved:
a. Proximal limb musclesb .Dilator pupillae
c. Extraocular muscle
d.Facial muscle
e. Palate
Ans. (B) Dilator pupillae
• In myasthenia gravis weakness typically begins with
extra-oculars muscles, patient presented
initially with ptosis
and diplopia.
• Papillary response is normal.
• Proximal muscle mainly involves.
• Facial weakness produces a “snarling” expression when
patient attempt to smile.
• Palatal weakness produced nasal regurgitation and nasal
intonation.
• Involvement of papillary muscle not mentioned.
