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Myasthenia Gravis

Myasthenia Gravis

  • In this disease the basic fault is at neuromuscular function. So mostly skeletal muscles of body are involved.
  • Symptoms are characterized by fluctuant / intermittent / temporary weakness of muscles of different parts of body Which is precipitated /aggravated by exercise / physical exertion & relieved by rest. So patient is better in morning after waking up from sleep. One may feel weakness after exertion. Hence it is also called Fatigue Paralysis.
  • When chest muscles are involved the patient feels breathless on exertion which may be misinterpreted as heart & lung problem. Severe involvement of chest muscles is medical emergency.
  • Different muscles of body are not involved equally so symptoms will vary depending on degree of involvement of different muscles.
  • Common Symptoms: Drooping of lids, Double Vision , Difficulty in chewing & swallowing, Change in voice (Nasal Twang) while prolonged talking. Breathlessness on exertion. Hand & legs weakness on exertion.
  • Relevant investigations done are anti acetylcholine receptor antibody in blood, CT, Scan / MRI of chest for detecting thymoma & Repetitive nerve stimulation.
Treatment :
  • Tab. Pyridostigmine / Neostigmine for symptomatic relief.
  • Disease modifying medicines
  • Thymus Surgery.
  • Plasmapheresis