[Myaesthenia Gravis] Flashcards
Myaesthenic snarl
preserved vertical but decreased horizontal excursion of lips
voice fades on counting to 50
Tendon reflexes normal
Females
Thymic hyperplasia
Males
thymic atrophy/tumours
nicotinic acetylcholine receptors
ocular muscle fatigue
difficulty swallowing/speaking
Shows orbicularis fatigue
Anti-AchR
70
MuSK (muscle specific tyrosine kinase)
Decremental muscle response
> 2mm
CT of thymus
Pyridostigmine (anticholinesterase)
Prednisolone
+ azathioprine/d
OR
Methotrexate /week
alternate days
Osteoporotic prophylaxis
methotrexate
azothioprine
Thymectomy
respiratory muscle fatigue during relapse
Forced vital capacity
FBC
LFT
ocular
(bulbar, face, neck, limb)
Truck
salivation
lacrimation
miosis
IV Immunoglobulin
life threatening weakness of respiratory muscles in relapse
<20mL/Kg
plasmapheresis
or
IV Ig
[lambert-eaton}: what is the difference in presentation between MG and LE myasthenic syndrome?
gait difficulty before eye signs
[lambert-eaton}: what is the pathophysiological cause of LES?
Antibodys against pre-synaptic membrane Calcium voltage channels
[lambert-eaton}:LES can be autoimmune or caused by …
small cell lung cancer (paraneoplastic)