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Myasthenia Gravis
It is an autoimmune disease of neuromuscular junctions characterized by fluctuating weakness of certain skeletal muscle groups. Causes: Emotional stress Secondary illness Temperature extremes Drugs eg. Aminoglycosides Beta adrenergic blockers Procainamide Phenytoin quinidine Psychotropic drugs Pregnancy, mensus Trauma Hypokalemia Lithium carbonate Phenothiazines Benzodiazepines Tricyclic antidepressants Neuromascular blocking agents Like succinyl choline

Clinical manifestations: Weakness of skeletal muscles, strength is restored by period of rest, muscles commonly involved are eyes and eyelids, chewing, swallowing, speaking and breathing. Impaired facial mobility and expressions Dysphagia, dysphasia

Diagnostic tests: EMG Tensillon test: i/v inj of anticholenergic edrophonium chroride (anti cholenestrase blocks the enzyme acetylcholenestrase) shows marked improvement.

Drug therapy: Anticholenergic: neostigmine, pyridostigmine Corticosteroids: prednisone Immunosupressants: azathioprine, cyclophosphamides Other therapies include plasmapheresis, i/v IgG, i/v immunoglobulins

Surgical therapy: Removal of thymus gland Prepared by Navjot and Kawal,Msc 2nd year, Mai Bhago College of Nursing, Tarn-Taran