Neuro History
 

Myaesthenia Gravis

 
 
Bookmark

Overview

    • Ask About

    • Diagnosis - when diagnosis was made, symptoms on presentation
    • Manifestations - past myaesthenic crisis / issues with anaesthetics in the past
    • Management - anticholinesterase agents, immunosuppression, thymectomy, past IVIg / plasmapheresis for crisis

Manifestations

    • Manifestations of Myaesthenia Gravis

    • Fatiguing muscle weakness (worse with use and improved with rest) affecting the eyes, face, oropharynx, trunk and limbs
    • Myaesthenic crisis (respiratory failure)
    • Precipitants of Myaesthenic Crisis

    • Infection
    • Surgical procedures
    • Drugs - neuromuscular blockers, aminoglycosides, macrolides, beta blockers, calcium channel blockers, corticosteroids
    • Pregnancy

Management

    • Management Options for Myaesthenia Gravis

    • Maintenance

    • Anticholinesterase agents - pyridostigmine, neostigmine
    • Immunosuppression (uncommonly)
    • Thymectomy
    • Myaesthenic Crisis

    • IV immunoglobulin
    • Plasmapheresis
    • Respiratory support
 
----------------------------------------------------------------------------------------------------------------------------------------------------------------------------
Want more info like this?
  • Your electronic clinical medicine handbook
  • Guides to help pass your exams
  • Tools every medical student needs
  • Quick diagrams to have the answers, fast
  • Quizzes to test your knowledge
Explore
   
 
 

Read More...

 Ascherio A, Munger KL. Environmental risk factors for multiple sclerosis. Part II: Noninfectious factors. Annals of Neurology: Official Journal of the American Neurological Association and the Child Neurology Society. 2007 Jun;61(6):504-13. Belbasis L, Bellou V, Evangelou E, Ioannidis JP, Tzoulaki I. Environmental risk factors and multiple sclerosis: an umbrella review of systematic reviews and meta-analyses. The Lancet Neurology. 2015 Mar 1;14(3):263-73. Dharmadasa T, Henderson RD, Talman PS, Macdonell RA, Mathers S, Schultz DW, Needham M, Zoing M, Vucic S, Kiernan MC. Motor neurone disease: progress and challenges. Medical Journal of Australia. 2017 May;206(8):357-62. Ferlisi M, Shorvon S. Seizure precipitants (triggering factors) in patients with epilepsy. Epilepsy & Behavior. 2014 Apr 1;33:101-5. Hajat C, Dundas R, Stewart JA, Lawrence E, Rudd AG, Howard R, Wolfe CD. Cerebrovascular Risk Factors and Stroke Subtypes: Differences Between Ethnic Groups. Stroke. 2001; 32: 37-42. Hayes MW, Fung VS, Kimber TE, O'Sullivan JD. Current concepts in the management of Parkinson disease. Medical Journal of Australia. 2010 Feb;192(3):144-9.
Jankovic J. Parkinson’s disease: clinical features and diagnosis. Journal of neurology, neurosurgery & psychiatry. 2008 Apr 1;79(4):368-76.
 Juel VC. Myasthenia gravis: management of myasthenic crisis and perioperative care. InSeminars in neurology 2004 Mar (Vol. 24, No. 01, pp. 75-81). Copyright© 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.. Keesey JC. Clinical evaluation and management of myasthenia gravis. Muscle & Nerve: Official Journal of the American Association of Electrodiagnostic Medicine. 2004 Apr;29(4):484-505. Kennedy A, Zakaria R. Taking a Neurological History. Medicine. 2006; 36(10): 509-514. Lima, Marco A. What is the essential neurological examination?. Arquivos de neuro-psiquiatria. 2012 Dec; 70(12): 939. McDermott CJ, Shaw PJ. Diagnosis and management of motor neurone disease. Bmj. 2008 Mar 20;336(7645):658-62. Murthy JM, Meena AK, Chowdary GV, Naryanan JT. Myasthenic crisis: clinical features, complications and mortality. Neurology India. 2005 Jan 1;53(1):37.
O'Brien MD. Taking a Neurological History. The Foundation Years. 2006; 2(1): 1-6.
Palace J. Making the diagnosis of multiple sclerosis. Journal of Neurology, Neurosurgery & Psychiatry. 2001 Dec 1;71(suppl 2):ii3-8.
 Pearl PL. Neurological Problems of Jazz Legends. Journal of Child Neurology. 2009 Aug; 24(8): 1037-1042.
Perlmutter JS. Assessment of Parkinson disease manifestations. Current protocols in neuroscience. 2009 Oct;49(1):10-.
 Sanders DB, Wolfe GI, Benatar M, Evoli A, Gilhus NE, Illa I, Kuntz N, Massey JM, Melms A, Murai H, Nicolle M. International consensus guidance for management of myasthenia gravis: executive summary. Neurology. 2016 Jul 26;87(4):419-25. Shorvon SD. The etiologic classification of epilepsy. Epilepsia. 2011 Jun;52(6):1052-7. Simpson S, Blizzard L, Otahal P, Van der Mei I, Taylor B. Latitude is significantly associated with the prevalence of multiple sclerosis: a meta-analysis. Journal of Neurology, Neurosurgery & Psychiatry. 2011 Oct 1;82(10):1132-41.
Talbot K. Motor neurone disease. Postgraduate medical journal. 2002 Sep 1;78(923):513-9.
Feedback