Disorders of the Neurological Junction (MG) Flashcards
Precautions during MG rehab:
- No exercise during exarcebations
- Stop exercise if symptoms worsen or SOB
- Fatigie should not last for more than 2 h post exercise
- Resudual muscle soreness should not be severe and resolve within a few days
Lambert-Eaton Syndrome AKA:
Lambert-Eaton Myasthenic Syndrome (LEMS)
acute care rehabilitation considerations of MG:
-
Acute care: supportive care
- PT stablishes accurate neurologic and respiratory baselines
- Be aware of myesthenic crisis:
- Increased wekaness
- respiratory distress
- dificulty talking, chewing, swallowing
Treatment of Botulism:
- Immediate
- Antitoxin injection
- Removal of unabsorbed toxin from GI
- ICU: intubation and mechanical ventalitaion may be needed
- Supportive care
In MG, an autoimmune response mediated by specific anti-ACh receptor antibodies that may:
- Block the site that normally binds ACh
- Damage postsynaptic muscle membrane
- Result in degeneration of the ACh receptors
Recently discovered types of Myesthenia Gravis:
Antibodies against MuSK protein
Prognosis of MG:
- Normal life with tretament
- Variable course: remission and exarcerbations
- Slowly progressive course
4 Older categories of MG:
- Ocular
- Mild generalized
- Acute fulminating
- Late severe
Rehabilitation Considerations of botulism:
Post-acute care:
- Graded, progressive rehab program to address:
- Muscle wasting
- Deconditioning
- Orthostatic hypotension
Generalized weakness in MG:
- Occurs in 85% of persons with MG-Affects limb musculature
- Usually more mild involvement
- Proximal muscles more affected than distal
- May see unstable, waddling gait-In more severe forms, can have respiratory muscle weakness
- No sensory loss
- Normal reflexes: because is a short contraction
Peak incidence of MG in females ages:
20’s – 30’s
Diagnosis of Lambert Eaton Syndrome:
- Decreased DTR
- Muscle atrophy
- Weakness that improves with activity
- Detection of voltage gated calcium channel
antibodies in serum - Positive Tensilon test
Treatment of Lambert Eaton Syndrome:
- Symptomatic: lung cancer treatment
- Other treatment similar to MG
Clinical features of Lambert-Eaton Syndrome:
- Weakness and fatigue of muscles
- Muscle Atrophy
- Little involvement of ocular muscles
- Depressed reflexes
- ¾ have autonomic involvement:
- Dry mouth
- Constipation
- Blurred vision
- Impaired sweating
- Orthostatic hypotension
True or false: reumatoid arthritis and lupus are risk factors of MG
True
Signs & symptoms of LEMS often precede what other serius condition?
Dx of cancer by 2 to 4 years
Cardinal feautures of MG:
- Skeletal muscle fluctuating weakness
- Skeletal Muscle fatigability
- Extraocular muscles 1st to be affected
Autoimmune disorder associated mainly with carcinoma of lung and may also be associated wuth DM I, Vitiligo, hypothyroidism?
Lambert-Eaton Syndrome
Transient Neonatal Myasthenia Gravis
- AChE antibodies can cross placenta
- Occurs in 10% of infants born to mothers
with MG