Thapa, LekhjungThapa, MonikaBhattarai, SumanShrestha, Abhishek ManSharma, NoomaRai, NilshanPokharel, MerinaPaudel, Raju2025-12-122025-12-122022https://hdl.handle.net/20.500.14572/3597Lekhjung Thapa Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal Monika Thapa Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal Suman Bhattarai Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal Abhishek Man Shrestha Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal Nooma Sharma Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal Nilshan Rai KIST Medical College and Teaching Hospital, Imadol, Lalitpur, Nepal Merina Pokharel Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, Nepal Raju Paudel Department of Neurology, National Neuro Center, Maharajgunj, Chakrapath, Kathmandu, NepalAbstract Myasthenia gravis is a neuromuscular junction disorder characterised by fluctuating muscle weakness, improved by using anti-cholinesterase drugs. In addition to the autoimmune aetiology, various factors such as infections, surgery, and drugs are known to precipitate the condition. We report a case of a 15-year-old boy with D-penicillamine-induced myasthenia gravis who presented with facial diplegia, dysphagia, and drooling of saliva, 6 years after the initiation of treatment for Wilson’s disease. Therefore, clinicians should be more vigilant while prescribing patients with chelating drugs like D-penicillamine with regular monitoring of the new symptoms and keeping a very low threshold for the suspicion of myasthenia gravis.en-USD-penicillamineMyasthenia gravisPyridostigmineWilson's diseaseOther