Hypernasalilty and Ptosis in a 48-yr-old Woman

Test Result 1

Results of appropriate testing return and show the following:

• EMG with repetitive nerve testing shows decremental response to 3-Hz stimulation in the left median nerve recording from the abductor pollicis brevis muscle and in the accessory nerve recording from the trapezius. The decrement is less pronounced after 10 sec of exercise (facilitation) and is more pronounced after a further 60 sec of exercise (postfacilitation exhaustion).

Serum:

Test (units)	Result	Results (SI Units)
Serum acetylcholine receptor antibody titer is 0.28 nmol/L	Normal reference range < 0.02 nmol/L	N/A
Serum creatine kinase is 50 U/L [833 nkat/L]	Normal reference range 30-170 U/L	500-2833 nkat/L