Myasthenia Gravis Flashcards
What receptors are affected by Myasthenia Gravis?
Nicotinic Acetylcholine
What is Myasthenia Gravis?
*Autoimmune disease
*Weakness in skeletal muscle
What is decreased in Myasthenia Gravis?
Transmission through the neuromuscular junction
What is the prevalence in the UK of Myasthenia Gravis?
15 per 100,000
What is the peak age for females getting Myasthenia Gravis?
20-30 years.
What is the peak age for males getting Myasthenia Gravis?
60-80 years.
What is the most common first symptom of a patient with Myasthenia Gravis?
Ocular symptoms
*Drooping eyelids (Ptosis)
*Double vision (Diplopia)
*restricted eye movements - worse when tired
-Also could have lack of facial expression
*Slurred speech
*Chewing/swallow issues
*weakness in arms, legs, necks,
*SOB
What is a myasthenic crisis?
Respiratory failure, requires a ventilator.
Why is Myasthenia Gravis hard to diagnose?
Symptoms fluctuate
How do you test for Myasthenia Gravis?
*Ice test - cooling improves the symptoms
*Blood test for auto-antibodies
*Electromyogram - decreases muscle response
*Edrophonium test - has side effects not often used.
*CAT scan to exclude thymoma
What is Thymoma
Thymic Carcinoma - Cancer
What percent of patient’s usually progress to other muscles?
80%
What percent of people can be affected by a Myasthenic crisis?
20%
What is first line treatment for Myasthenia Gravis?
Acetylcholinesterase inhibitors
*Pyridostigmine
*Symptom relief
These act at the NMJ
Can immunosuppressive therapy be given for Myasthenia Gravis?
Yes - Azathioprine, Ciclosporine
Can be given with Acetylcholinesterase inhibitors
