Abstract Clinical case. We report the case of a 92-year-old quadriparetic patient who suddenly presented a major swallowing disorder following trauma o the neck. A diagnosis of myasthenia gravis was suggested by single-fibre EMG of the extensor digitorum communis muscle. In view of the ontinued absence of dysphagia after 6 months of pyridostigmine treatment, this diagnosis was considered as definitive. Discussion. We review the various characteristics of myasthenia gravis and ways of investigating dysphagia. Conclusion. It is important to be aware of and investigate all the direct and indirect signs of dysphagia and establish the exact ogy in order o provide the best possible treatment. 2009 Elsevier Masson SAS. All rights reserved.