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Myasthenia Gravis

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Gravitax, a combination of iron, aloe vera, and apiaceae First discription of MG in 1672 1935 Prostigmin Demonstration for MG Sources Daniel, Moshe. – PowerPoint PPT presentation

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Title: Myasthenia Gravis


1
Myasthenia Gravis
  • Mike Willcut

2
Myasthenia What?
  • My-as-thee-nee-ah Grr-a-vis
  • Auto immune disease
  • Hereditary genetic mutation
  • Causes muscle weakness

3
Where have I heard that?
  • Contraindication for
  • Versed
  • Fentanyl
  • Precaution for sux

4
Pathophysiology
  • Auto Immune
  • Antibodies attack Ach Receptors
  • Decreased cell excitement
  • Electrical threshold
  • No action potential
  • Weakness

5
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6
Cell with MG
7
This might be on the Quiz
  • How does MG affect the body?
  • A Blocks motor receptors causing weakness
  • B - Increases stimulus threshold
  • C - Decreases stimulus threshold
  • D - Reduces amount of Ach released causing
    weakness

8
Classification
  • 1 Eye muscle weakness (EMW)
  • 2 EMW and other mild muscle weakness
  • Predominantly limb or axial muscles
  • Predominantly bulbar or respiratory muscles
  • 3 EMW and other moderate weakness
  • Predominantly limb or axial muscles
  • Predominantly bulbar or respiratory muscles
  • 4 EMW and other severe weakness
  • Predominantly limb or axial muscles
  • Predominantly bulbar or respiratory muscles
  • 5 Intubation needed to maintain airway

9
Whos at Risk
  • Females 20-40
  • Males 60-80
  • Those with another AI Disease
  • Penicillamine users (rheumatoid med)
  • Enlarged Thymus or thymoma
  • 20 in 100,000 or 2 in 1million (discrepancy)

10
Diseases Typically Associated With MG
  • Diabetes Type 1
  • Rheumatoid Arthritis
  • Lupus
  • Demyelination CNS Disease
  • Other Auto immune diseases

11
What will we see?
  • Hallmark S/S
  • Eye lid drooping (ptosis)
  • Impaired speech (dysarthria)
  • Difficulty Swallowing (dysphagia)
  • Double Vision (dipoplia)
  • Easily fatigued, quick recovery with rest
  • Waddling gait

12
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13
Physical Exam
  • Test for muscle fatigueability
  • Look up and to the side for 30 sec
  • If supine, look at feet for 1min
  • Arms stretched forward for 1min
  • 10 deep knee bends or squats
  • Look for ptosis and ask about diplopia

14
Myasthenia Crisis
  • Requires immediate assistance
  • Shortness of breath
  • Extreme muscle weakness
  • General fatigueablility
  • Respiratory muscle paralysis

15
MG in Pregnancy
  • Many mothers get worse 1st trimester and better
    2nd and 3rd trimester.
  • Up to 10 of infants born to mothers with MG will
    have Transient Neonatal Myasthenia.
  • Weak cry, poor muscle tone, difficulty breathing
    etc

16
Interventions
  • Depending on severity
  • RSI
  • Supportive care

17
Triggers
  • May be triggered by
  • Infection
  • Stress
  • Fever
  • Adverse reaction to medications

18
Hospital Tests
  • Blood tests
  • Tests for specific antibodies
  • Only 50 accurate
  • CT
  • Chest X-Ray
  • Endrophonium Test
  • IV injection of acetylcholinesterase inhibitor

19
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20
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21
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22
Treatment
  • Actylcholinesterase inhibitors
  • Corticosteroids immunosuppressants
  • Thymectomy
  • Plasmapheresis
  • Like dialysis

23
Naturopathic Treatment
  • Counseling sessions
  • Eliminate stress and poor self image
  • Diet and nutrition
  • Moshe Daniel ND

24
Prognosis
  • Very Good!
  • Most get relief from simple treatment
  • Some go into remission
  • Only 2-3 mortality rate

25
Fun Facts
  • Radix family of Chinese herbs can help with
    symptoms.
  • Gravitax, a combination of iron, aloe vera, and
    apiaceae
  • First discription of MG in 1672
  • 1935 Prostigmin Demonstration for MG

26
Sources
  • Daniel, Moshe. "The Treatment and Philosophy of
    Healing For Myasthenia Gravis ." 29 Sep 2007 12
    Dec 2008 lthttp//www.thelastfourbooks.com/myasthen
    ia_gravis_alternative_medicine_cure.htmlgt.
  • Howard, James, F. "About Myasthenia Gravis." For
    Health Care Professionals 30 Sep 2006 12 Dec 2008
    lthttp//www.myasthenia.org/amg_whatismg.cfmgt.
  • "Myasthenia gravis." Wikipedia. 2008. Wikimedia
    Foundation Inc. 12 Dec 2008 lthttp//en.wikipedia.o
    rg/wiki/Myasthenia_gravisgt.
  • "What causes Myasthenia Gravis." Myasthenia
    Gravis Fact Sheet 25 Jul 2008 12 Dec 2008
    lthttp//www.ninds.nih.gov/disorders/myasthenia_gra
    vis/detail_myasthenia_gravis.htmgt.

27
Thats All
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