myasthenia grvis

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  1. What is myasthenia gravis?
    • Autoimmune chronic disease
    • Affects nervous system causing fatigue/muscle weakness
  2. Cause
    • Autoantibody attack of acetylcholine receptors at muscle end plate
    • nervous impulses are not transmitted & muscles cannot contract
  3. Patho
    • Hyperplasia of thymus gland-in some cases a tumor (thymoma)
    • Hyperthyroidism has strong association
    • Exacerbation period- heat, infection, stress, fatigue, cathartics
  4. Motor manifestations
    • Fatigue
    • Muscle weakness- resolves c rest
    • Poor posture
    • Ptosis
    • Diplopia
    • Loss of bowel/bladder control
    • Resp compromise
  5. Sensory manifestations
    • Muscle aches
    • Paresthesia
    • Reduced smell/taste
  6. Diagnostics
    • Thyroid function
    • SPE
    • Acetylcholine receptor testing
    • Tensilon testing
    • Electromyography
  7. Nonsurgical interventions
    • Respiratory support
    • Promote mobility
    • Drug therapy
    • Plasmapheresis
  8. Myasthenia crisis (exacerbation)
    • Often caused by infection or not enough anticholenergic drug
    • Pt at risk for anticholinesterase drug overdose
    • Resp system is compromised
    • Pt might require mechanical ventilation
    • S/S-increased resp, HR, BP; anoxia; cyanosis; B/B inc; decreased urine output; absence of cough/swallow reflex
  9. Cholinergic crisis (acute exacerbation)
    • Increased muscle weakness due to overdose of anticholinesterase drug.
    • S/S-N/V; diarrhea, abd cramps, blurred vision, pallor, facial muscle twitching, hypotension
  10. Surgical intervention
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myasthenia grvis
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