Myasthenia Gravis

Posted by e-Medical PPT Sunday, August 22, 2010
Myasthenia gravis is an autoimmune neuromuscular disorder leading to fluctuating muscle weakness and fatiguability caused by circulating antibodies that block acetylcholine receptors at the post-synaptic neuromuscular junction inhibiting the stimulative effect of the neurotransmitter acetylcholine.There is a slight genetic predisposition: particular HLA types seem to predispose for MG . Up to 75% of patients have an abnormality of the thymus; 25% have a thymoma, , and other abnormalities are frequently found. Myasthenia is treated medically with cholinesterase inhibitors or immunosuppressants.For emergency treatment, plasmapheresis or IVIG can be used as a temporary measure to remove antibodies from the blood circulation.The disease process generally remains stationary after thymectomy in selected cases.
The hallmark of myasthenia gravis is fatiguability. Muscles become progressively weaker during periods of activity and improve after periods of rest. In most cases, the first noticeable symptom is weakness of the eye muscles. In others, difficulty in swallowing and slurred speech may be the first signs. The degree of muscle weakness involved in MG varies greatly among patients, ranging from a localized form that is limited to eye muscles (ocular myasthenia), to a severe and generalized form of myasthenia.Symptoms, which vary in type and severity, may include asymmetrical ptosis , diplopia due to weakness of the muscles that control eye movements, an unstable or waddling gait, weakness in arms, hands, fingers, legs, and neck, a change in facial expression, dysphagia , shortness of breath and dysarthria.

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