7. This might be on the Quiz
How does MG affect the body?
A – Blocks motor receptorsA – Blocks motor receptors
causing weaknesscausing weakness
B - Increases stimulus threshold
C - Decreases stimulus threshold
D - Reduces amount of Ach
released causing weakness
8. Classification
1: Eye muscle weakness (EMW)
2: EMW and other mild muscle weakness
a. Predominantly limb or axial muscles
b. Predominantly bulbar or respiratory muscles
3: EMW and other moderate weakness
a. Predominantly limb or axial muscles
b. Predominantly bulbar or respiratory muscles
4: EMW and other severe weakness
a. Predominantly limb or axial muscles
b. Predominantly bulbar or respiratory muscles
5: Intubation needed to maintain airway
9. Who’s at Risk
Females 20-40
Males 60-80
Those with another AI Disease
Penicillamine users (rheumatoid med)
Enlarged Thymus or thymoma
20 in 100,000 or 2 in 1million
(discrepancy)
10. Diseases Typically
Associated With MG
• Diabetes Type 1
Rheumatoid Arthritis
Lupus
Demyelination CNS Disease
Other Auto immune diseases
11. What will we see?
Hallmark S/S
Eye lid drooping (ptosis)
Impaired speech (dysarthria)
Difficulty Swallowing (dysphagia)
Double Vision (dipoplia)
Easily fatigued, quick recovery with rest
Waddling gait
12.
13. Physical Exam
Test for muscle fatigueability
Look up and to the side for 30 sec
If supine, look at feet for 1min
Arms stretched forward for 1min
10 deep knee bends or squats
Look for ptosis and ask about diplopia
15. MG in Pregnancy
Many mothers get worse 1st
trimester and better 2nd and 3rd
trimester.
Up to 10% of infants born to
mothers with MG will have
Transient Neonatal Myasthenia.
Weak cry, poor muscle tone, difficulty
breathing etc…
17. Triggers
May be triggered by:
Infection
Stress
Fever
Adverse reaction to medications
18. Hospital Tests
Blood tests
Tests for specific antibodies
Only 50% accurate
CT
Chest X-Ray
Endrophonium Test
IV injection of acetylcholinesterase inhibitor
24. Prognosis
Very Good!
Most get relief from simple treatment
Some go into remission
Only 2-3% mortality rate
25. Fun Facts
Radix family of Chinese herbs can
help with symptoms.
Gravitax, a combination of iron,
aloe vera, and apiaceae
First discription of MG in 1672
1935 Prostigmin Demonstration for
MG
26. Sources
Daniel, Moshe. "The Treatment and Philosophy of
Healing For Myasthenia Gravis ." 29 Sep 2007 12
Dec 2008
<http://www.thelastfourbooks.com/myasthenia_grav
is_alternative_medicine_cure.html>.
Howard, James, F. "About Myasthenia Gravis." For
Health Care Professionals 30 Sep 2006 12 Dec
2008
<http://www.myasthenia.org/amg_whatismg.cfm>.
"Myasthenia gravis." Wikipedia. 2008. Wikimedia
Foundation Inc. 12 Dec 2008
<http://en.wikipedia.org/wiki/Myasthenia_gravis>
.
"What causes Myasthenia Gravis." Myasthenia
Gravis Fact Sheet 25 Jul 2008 12 Dec 2008
<http://www.ninds.nih.gov/disorders/myasthenia_g
ravis/detail_myasthenia_gravis.htm>.