The patient, a 53-year-old female, was admitted to the hospital with “ptosis of the eyelid for one month, weakness in swallowing, and slurred speech for half a month”. The patient presented with no obvious cause of left eyelid ptosis, which was heavy in the morning and evening, and gradually developed left facial muscle dysmotility, weakness in swallowing, and slurred speech. The patient was seen at the local hospital in the department of quintuplegia and the department of neurology, and no special abnormalities were found on cranial CT, MRI and cerebral angiography. On 3-23, the patient started to take bromipyridamole 60mg Tid orally, and her symptoms were significantly relieved. The patient was admitted to our outpatient clinic with “myasthenia gravis and thymic hyperplasia” for further diagnosis and treatment. Since the onset of the disease, the patient’s spirit, sleep, appetite, urine and stool were normal, and there was no significant change in weight. Physical examination: fatigue test (+) and pathological signs (-) on neurological examination. Preoperative diagnosis: myasthenia gravis, thymic hyperplasia . On April 2, 2013, an enlarged thoracoscopic thymectomy was performed under general anesthesia through the left thoracic approach. The patient recovered smoothly after surgery and her symptoms were relieved. Shenzhen Yun, Department of Thoracic and Cardiovascular Surgery, Aviation General Hospital of China Medical University, discussed: The patient was a middle-aged female with a one-month history of disease. The patient had typical symptoms of myasthenia gravis and was sensitive to bromipyridamole. The diagnosis of myasthenia gravis was basically clear, which was further confirmed by electromyography, which showed decreasing waves of repetitive low-frequency electrical stimulation. The CT of the chest suggests thymic hyperplasia, and most of the myasthenia gravis combined with thymic hyperplasia can be relieved or cured by enlarged thymectomy. The patient’s thymic hyperplasia is biased to the left side of the thoracic cavity, and the nature of the hyperplasia is considered benign, so thoracoscopic surgery can be performed via the left thorax. The three types of crisis are difficult to distinguish and can be treated with ventilator-assisted respiration, and tracheotomy is necessary if the patient cannot be taken off the machine for a long time.