Myasthenia Gravis (silver)

Question 1

What is Myasthenia Gravis?

Answer 1

Autoimmune disorder, disrupting transmission of neuromuscular signals leading to weakness and fatigue.

Question 2

What structure is involved/damaged?

Answer 2

Neuromuscular junction, acetylcholine receptors.

Question 3

Most likely contributing factor?

Answer 3

Exact etiology unknown.

However:

• Majority have abnormalities of the thymus gland (tumor, hyperplasia)

Question 4

Are women or men more likely to be more affected?

Answer 4

Women

Question 5

Clinical Presentation

Answer 5

• Weakness of the muscles
• Muscles fatigue quickly (rest can quickly improve function)
• Diplopia. Ptosis
• Impaired chewing, swallowing, speech

Question 6

Are proximal or distal muscles more affected?

Answer 6

Proximal

Question 7

What may exacerbate symptoms?

Answer 7

• Activity
• Heat
• Stress
• Illness

Question 8

Laboratory or imaging studies to confirm the diagnosis?

Answer 8

• Blood testing for antibodies
• Electromyography, to stimulate rapid fatigue
• X-ray, CT, MRI if thymus involved.

Question 9

Why are pulmonary function test utilized?

Answer 9

To determine if respiratory muscles have been affected.

Question 10

Most effective management?

Answer 10

Medications that inhibit Acetylcholinesterase

Corticosteroids to help suppress the immune system

Surgical intervention to remove the thymus; thymectomy

Question 11

What is Plasmapheresis used for?

Answer 11

Serious cases of acute worsening of symptoms.

• To remove antibodies from the blood.