User:Mr. Ibrahem/Myasthenia gravis

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Myasthenia gravis
Eye deviation and a drooping eyelid in a person with myasthenia gravis trying to open her eyes
SpecialtyNeurology
SymptomsVarying degrees muscle weakness, double vision, drooping eyelids, trouble talking, trouble walking[1]
Usual onsetWomen under 40, men over 60[1]
DurationLong term[1]
CausesAutoimmune disease[1]
Diagnostic methodBlood tests for specific antibodies, edrophonium test, nerve conduction studies[1]
Differential diagnosisGuillain–Barré syndrome, botulism, organophosphate poisoning, brainstem stroke[2]
TreatmentMedications, surgical removal of the thymus, plasmapheresis[1]
MedicationAcetylcholinesterase inhibitors (neostigmine, pyridostigmine), immunosuppressants[1]
Frequency50 to 200 per million[3][4]

Myasthenia gravis (MG) is a long-term neuromuscular disease that leads to varying degrees of skeletal muscle weakness.[1] The most commonly affected muscles are those of the eyes, face, and swallowing.[1] It can result in double vision, drooping eyelids, trouble talking, and trouble walking.[1] Onset can be sudden.[1] Those affected often have a large thymus or develop a thymoma.[1]

Myasthenia gravis is an autoimmune disease which results from antibodies that block or destroy nicotinic acetylcholine receptors at the junction between the nerve and muscle.[1] This prevents nerve impulses from triggering muscle contractions.[1] Some medicines may worsen the weakness.[5] Rarely, an inherited genetic defect in the neuromuscular junction results in a similar condition known as congenital myasthenia.[6][7] Babies of mothers with myasthenia may have symptoms during their first few months of life, known as neonatal myasthenia.[1] Diagnosis can be supported by blood tests for specific antibodies, the edrophonium test, or a nerve conduction study.[1]

Myasthenia gravis is generally treated with medications known as acetylcholinesterase inhibitors such as neostigmine and pyridostigmine.[1] Immunosuppressants, such as prednisone or azathioprine, may also be used.[1] The surgical removal of the thymus may improve symptoms in certain cases.[1] Plasmapheresis and high dose intravenous immunoglobulin may be used during sudden flares of the condition.[1] If the breathing muscles become significantly weak, mechanical ventilation may be required.[1] Once intubated acetylcholinesterase inhibitors may be temporarily held to reduce airway secretions.[8]

MG affects 50 to 200 per million people.[3][4] It is newly diagnosed in three to 30 per million people each year.[9] Diagnosis is becoming more common due to increased awareness.[9] It most commonly occurs in women under the age of 40 and in men over the age of 60.[1] It is uncommon in children.[1] With treatment, most of those affected lead relatively normal lives and have a normal life expectancy.[1] The word is from the Greek "mys" "muscle" and "astheneia" "weakness", and the Latin "gravis" "serious".[10]

References[edit]

  1. ^ a b c d e f g h i j k l m n o p q r s t u v w x "Myasthenia Gravis Fact Sheet". NINDS. 10 May 2016. Archived from the original on 27 July 2016. Retrieved 8 August 2016.
  2. ^ Kahan, Scott (2005). In a Page: Neurology. Lippincott Williams & Wilkins. p. 118. ISBN 978-1-4051-0432-6. Archived from the original on 8 September 2017.
  3. ^ a b Kaminski, Henry J. (2009). Myasthenia Gravis and Related Disorders (2 ed.). Springer Science & Business Media. p. 72. ISBN 978-1-59745-156-7. Archived from the original on 8 September 2017.
  4. ^ a b Adams, James G. (2012). Emergency Medicine: Clinical Essentials (2 ed.). Elsevier Health Sciences. p. 844. ISBN 978-1-4557-3394-1. Archived from the original on 8 September 2017.
  5. ^ "Emergent Management of Myasthenia Gravis: Overview, Patient History, Physical Examination". emedicine. 20 September 2018. Archived from the original on 5 November 2021. Retrieved 1 February 2022.
  6. ^ Principles of Neural Science (5 ed.). 2012. pp. 318–319. {{cite book}}: Cite uses deprecated parameter |authors= (help)
  7. ^ Vrinten C, van der Zwaag AM, Weinreich SS, Scholten RJ, Verschuuren JJ (December 2014). "Ephedrine for myasthenia gravis, neonatal myasthenia and the congenital myasthenic syndromes". The Cochrane Database of Systematic Reviews. 12 (12): CD010028. doi:10.1002/14651858.CD010028.pub2. PMID 25515947.
  8. ^ Godoy, DA; Mello, LJ; Masotti, L; Di Napoli, M (September 2013). "The myasthenic patient in crisis: an update of the management in Neurointensive Care Unit". Arquivos de Neuro-psiquiatria. 71 (9A): 627–39. doi:10.1590/0004-282X20130108. PMID 24141444.
  9. ^ a b McGrogan A, Sneddon S, de Vries CS (2010). "The incidence of myasthenia gravis: a systematic literature review". Neuroepidemiology. 34 (3): 171–183. doi:10.1159/000279334. PMID 20130418.
  10. ^ Ehrlich, Ann; Schroeder, Carol L. (2014). Introduction to Medical Terminology. Cengage Learning. p. 87. ISBN 978-1-133-95174-2. Archived from the original on 8 September 2017.
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