Paramivir is a new anti-influenza virus drug that is a neuraminidase inhibitor and has been shown to be effective against influenza A and B in existing clinical trials. According to the World Health Organization, H7N9 is a subtype of influenza A virus, and preliminary trial results suggest that neuraminidase inhibitors may work against this virus. A recent article in Muscle & Nerve suggests that the drug has the potential to induce a crisis when used in a patient with myasthenia gravis. The patient, a 73-year-old woman, was diagnosed at age 68 with ptosis, dysphagia and slurred speech, treated with prednisone and tacrolimus, and was negative for low-frequency repetitive electrical stimulation on follow-up at age 72. The patient went to the local hospital with fever and cough and was diagnosed with influenza A. He was given paramivir 300 mg intravenously, and 20 minutes later he developed respiratory distress, decreased oxygen saturation and unconsciousness, and soon developed cardiopulmonary insufficiency, and was extubated and resuscitated. The next day the patient recovered consciousness, spontaneous respiration was enhanced, but eyelid drooping was evident, and 31.9% low-frequency attenuation of repetitive electrical stimulation was checked. 3 days later the patient’s respiratory function was further restored and the ventilator mode was changed from volume control to pressure support, while plasma exchange and propofol therapy were given. 9 days later respiratory function was further improved and the trachea was extubated. Repeated electrical stimulation was normalized at 12 days of discharge. Although there are many factors that induce crisis in MG patients, and infection is a common cause, this patient, who was otherwise stable, developed respiratory failure rapidly after 20 minutes of paramivir and then improved rapidly in symptoms and electrophysiology after symptomatic supportive therapy, which is difficult to explain by the original influenza A. It has been reported in the literature that neuraminidase inhibitors can inhibit ion channels or receptors, and by this case it should be brought to the attention of clinicians that the possibility that paramivir may aggravate the symptoms of MG patients by inhibiting ion channels or receptors in the neuromuscular junction cannot be ruled out, but of course more clinical evidence is needed to support this.