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DEFINITION:
• Myasthenia gravis is an autoimmune
  disorder affecting the myoneural
  junction, is characterized by varying
  degrees of weakness of the voluntary
  muscles.
CAUSES:
• In MG, the receptors at the muscle
  surface are destroyed or deformed by
  antibodies that prevent a normal
  muscular reaction from occurring.
• The causative factor is unknown, but the
  disorder may have a genetic link.
RISK FACTORS:

Risk factors for myasthenia gravis
  include:
• Female gender and age under 40 years
• Male gender and age over 60 years
• Other autoimmune disorders
Factors that can worsen myasthenia
                    gravis
•   Fatigue
•   Illness
•   Stress
•   Extreme heat
•   Some medications — such as beta
    blockers, calcium channel blockers,
    quinine and some antibiotics
PATHO PHYSIOLOGY:


    POSTER
SIGN AND SYMPTOMS:

• Diplopia and ptosis
• Weakness of the muscles of the face and
  the throat, and generalized weakness.
  Weakness of the facial muscles results in
  bland facial expression.

• Laryngeal irritation causes voice
  impairment and dysphonias and
  increases the patient’s risk for choking
  and aspiration.
• Generalized weakness of all the
  extremities and the intercoastal
  muscles resulting in decreased
  respiratory capacity and vital capacity.

• Myasthenia gravis is purely a motor
  disorder with no effect on the
  sensation and coordination.
DIAGNOSTIC TEST:

• Edrophonium test:

 Injection of the chemical edrophonium
 (Tensilon) may result in a sudden,
 although temporary, improvement in
 muscle strength - an indication that
 patient may have myasthenia gravis.
Blood analysis

• A blood test may reveal the presence of
  abnormal antibodies that disrupt the
  receptor sites where nerve impulses
  signal muscles to move.
Ice Pack Test

• Cooling may improve
  neuromuscular transmission. In a
  patient with myasthenia gravis who
  has ptosis, placing ice over an
  eyelid will lead to cooling of the lid,
  which leads to improvement of the
  ptosis.
• Repetitive nerve stimulation

• Pulmonary function tests
MEDICAL MANAGEMENT:

• Cholinesterase inhibitors.
• Corticosteroids
• Immunosuppressant



Plasmapheresis
SURGICAL MANAGEMENT
DIETARY MANAGEMENT
• Reduce protein intake to 10 percent of
  total calories; replace animal protein as
  much as possible with plant protein
• Eliminate milk and milk products
  (substitute other calcium sources).
• Eat more fruits and vegetables (make
  sure that they are organically grown).
• Eliminate polyunsaturated vegetable
  oils, margarine, vegetable shortening, all
  partially hydrogenated oils, and all foods
  (such as deep-fried foods) that might
  contain trans-fatty acids. Use extra-virgin
  olive oil as your main fat.

• Take ginger.
NURSING MANAGEMENT
• Ineffective breathing pattern related to
  intercoastal muscle weakness

• Impaired verbal communication related
  to weakness of the larynx ,lips, mouth,
  paharynx and jaw
• Impaired physical mobility related to
  voluntary muscle weakness

• Risk for aspiration related to weakness of
  the bulbar muscles

• Disturbed sensory perception related to
  ptosis,and decreased eye movements.
ASSIGNMENT


Write down Nursing Care plan of patient
        with Myasthenia Gravis.
BIBLIOGRAPHY
Myasthenia gravis

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Myasthenia gravis

  • 1.
  • 2.
  • 3. DEFINITION: • Myasthenia gravis is an autoimmune disorder affecting the myoneural junction, is characterized by varying degrees of weakness of the voluntary muscles.
  • 4. CAUSES: • In MG, the receptors at the muscle surface are destroyed or deformed by antibodies that prevent a normal muscular reaction from occurring. • The causative factor is unknown, but the disorder may have a genetic link.
  • 5. RISK FACTORS: Risk factors for myasthenia gravis include: • Female gender and age under 40 years • Male gender and age over 60 years • Other autoimmune disorders
  • 6. Factors that can worsen myasthenia gravis • Fatigue • Illness • Stress • Extreme heat • Some medications — such as beta blockers, calcium channel blockers, quinine and some antibiotics
  • 8. SIGN AND SYMPTOMS: • Diplopia and ptosis
  • 9. • Weakness of the muscles of the face and the throat, and generalized weakness. Weakness of the facial muscles results in bland facial expression. • Laryngeal irritation causes voice impairment and dysphonias and increases the patient’s risk for choking and aspiration.
  • 10. • Generalized weakness of all the extremities and the intercoastal muscles resulting in decreased respiratory capacity and vital capacity. • Myasthenia gravis is purely a motor disorder with no effect on the sensation and coordination.
  • 11. DIAGNOSTIC TEST: • Edrophonium test: Injection of the chemical edrophonium (Tensilon) may result in a sudden, although temporary, improvement in muscle strength - an indication that patient may have myasthenia gravis.
  • 12. Blood analysis • A blood test may reveal the presence of abnormal antibodies that disrupt the receptor sites where nerve impulses signal muscles to move.
  • 13. Ice Pack Test • Cooling may improve neuromuscular transmission. In a patient with myasthenia gravis who has ptosis, placing ice over an eyelid will lead to cooling of the lid, which leads to improvement of the ptosis.
  • 14. • Repetitive nerve stimulation • Pulmonary function tests
  • 15. MEDICAL MANAGEMENT: • Cholinesterase inhibitors. • Corticosteroids • Immunosuppressant Plasmapheresis
  • 17. DIETARY MANAGEMENT • Reduce protein intake to 10 percent of total calories; replace animal protein as much as possible with plant protein • Eliminate milk and milk products (substitute other calcium sources). • Eat more fruits and vegetables (make sure that they are organically grown).
  • 18. • Eliminate polyunsaturated vegetable oils, margarine, vegetable shortening, all partially hydrogenated oils, and all foods (such as deep-fried foods) that might contain trans-fatty acids. Use extra-virgin olive oil as your main fat. • Take ginger.
  • 19. NURSING MANAGEMENT • Ineffective breathing pattern related to intercoastal muscle weakness • Impaired verbal communication related to weakness of the larynx ,lips, mouth, paharynx and jaw
  • 20. • Impaired physical mobility related to voluntary muscle weakness • Risk for aspiration related to weakness of the bulbar muscles • Disturbed sensory perception related to ptosis,and decreased eye movements.
  • 21.
  • 22. ASSIGNMENT Write down Nursing Care plan of patient with Myasthenia Gravis.
  • 23.