Unit 2: Guillain-Barre + Myasthenia Gravis + Trigeminal Neuralgia

Question 1

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Autoimmune

Answer 1

BOTH!

Question 2

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Chronic disease

Answer 2

MG

Question 3

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Normal lifespan

Answer 3

MG

Question 4

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Immune system attacks Ach receptors at neuromuscular junctions of voluntary muscles.

Answer 4

MG

Question 5

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Immune system attacks nerves, damaging myelin sheaths and causing inflammation of nerves.

Answer 5

GB

Question 6

3 Phases of GB

Answer 6

1. Progressive (days to weeks; peaks at 1-2 weeks)
2. Plateau (weeks-months)
3. Recovery (months-years)

Question 7

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Bilateral Paraesthesias progressing to Paralysis

Answer 7

GB

Question 8

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Dysarthria, Dysphagia, difficulty chewing

Answer 8

BOTH!

Question 9

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Loss of DTRs

Answer 9

GB

Question 10

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Bowel and Bladder dysfunction

Answer 10

GB

Question 11

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Vagus nerve involvement

Answer 11

GB

Question 12

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Respiratory Failure

Answer 12

BOTH! May require mechanical ventilation
GB - Respiratory distress syndrome
MG - Respiratory failure

Question 13

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Dysrhythmias, MI

Answer 13

GB
Stress cardiomyopathy

Question 14

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Hypo/Hyperthyroidism

Answer 14

MG

Question 15

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Thymus gland tumor

Answer 15

MG

Question 16

What are the 2 Tx goals for GB?

Answer 16

1. Sx Management
2. Decrease Duration

Question 17

What is the main goal for MG?

Answer 17

1. Sx Management

Question 18

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Plasmapheresis, IV IgG drug therapy

Answer 18

BOTH!

Question 19

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Chest physiotherapy, assisted cough, suctioning

Answer 19

MG

Question 20

Guillain Barre (GB) or Myasthenia Gravis (MG)?
Tensilon Challenge Test

Answer 20

MG

Question 21

Cholinergic Crisis or Myasthenic Crisis
General muscle weakness, mydriasis
Improved muscle tone following Tensilon challenge test

Answer 21

Myasthenic Crisis (Acute exacerbation)
too little cholinesterase inhibitor drugs

Question 22

Cholinergic Crisis or Myasthenic Crisis
General muscle weakness, miosis
Decreased muscle tone following Tensilon challenge test

Answer 22

Cholinergic Crisis (Anticholinergic overdose)
too much cholinesterase inhibitor drugs
cause parasympathomimetic effects

Question 23

Cholinergic Crisis or Myasthenic Crisis
Tx: Ventilator support, Atropine

Answer 23

Cholinergic crisis

Question 24

Cholinergic Crisis or Myasthenic Crisis
Tx: ventilator support, Pyrdiostigmine

Answer 24

Myasthenic crisis

Question 25

Guillain Barre (GB) or Myasthenia Gravis (MG)?

Question 26

Trigeminal Neuralgia (TN) affects Cranial nerve _

Answer 26

CN V

Question 27

TN most often diagnosed by

Answer 27

Dentist

Question 28

TN occurs more often in..

Answer 28

Women >50 years

Question 29

Is there a cure for TN?

Answer 29

No :(
Focus on avoiding trigers + Pain Mx

Question 30

What’s the biggest risk r/t TN?

Answer 30

Psychosocial problems!
Depression, fear of pain, self-harm

Question 31

Drug therapy for TN (3 drug classes)

Answer 31

1. Pain meds (baclofen, gabapentin, pregabalin)
2. Anticonvulsants/Antiepileptics (carbamazapine, lamotrigine)
3. Nerve Block

Question 32

Surgery for TN (3)

Answer 32

1. Microvascular decompression
2. Stereotactic radiosurgery of CN V
3. Percutaneous procedures