What are the differential diagnosis of myasthenia gravis?
Differential diagnosis includes congenital myasthenic syndromes, Lambert Eaton syndrome, botulism, organophosphate intoxication, mitochondrial disorders involving progressive external ophthalmoplegia, acute inflammatory demyelinating polyradiculoneuropathy (AIDP), motor neuron disease, and brainstem ischemia.
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What are the differential diagnosis of myasthenia gravis?
Differential diagnosis includes congenital myasthenic syndromes, Lambert Eaton syndrome, botulism, organophosphate intoxication, mitochondrial disorders involving progressive external ophthalmoplegia, acute inflammatory demyelinating polyradiculoneuropathy (AIDP), motor neuron disease, and brainstem ischemia.
What is the difference between myasthenia gravis and myasthenic crisis?
Myasthenic crisis is a complication of myasthenia gravis characterized by worsening of muscle weakness, resulting in respiratory failure that requires intubation and mechanical ventilation. Advances in critical care have improved the mortality rate associated with myasthenic crisis.
What is the most common cause of myasthenic crisis?
The most common cause of myasthenic crisis often is infection, although idiopathic causes are also common. Many other factors influence cholinergic transmission, including drugs, temperature, and emotional state.
What is myasthenia gravis misdiagnosed?
Beware: there are other diseases that mimic myasthenia gravis. A number of disorders may mimic MG, including generalized fatigue, amyotrophic lateral sclerosis (ALS), Lambert-Eaton myasthenic syndrome, botulism, penicillamine-induced myasthenia, and congenital myasthenic syndromes.
What is cholinergic crisis?
A cholinergic crisis is an over-stimulation at a neuromuscular junction due to an excess of acetylcholine (ACh), as a result of the inactivity of the AChE enzyme, which normally breaks down acetylcholine.
How Edrophonium differentiate between myasthenia gravis and cholinergic crisis?
Symptoms and diagnosis Flaccid paralysis resulting from cholinergic crisis can be distinguished from myasthenia gravis by the use of the drug edrophonium (Tensilon), as it only worsens the paralysis caused by cholinergic crisis but strengthens the muscle response in the case of myasthenia gravis.
What does a myasthenic crisis look like?
A myasthenic crisis may come on slowly or very quickly. Difficult or labored breathing is the main symptom. You may notice that your breaths are shallow or your muscles seem too weak to move air in and out as you try to breathe.
Can myasthenia gravis be misdiagnosed as ALS?
ALS is commonly misdiagnosed as cerebrovascular disease, cervical myelopathy, vertebral disc herniation, radiculopathy, neuropathy, and myasthenia gravis. Misdiagnosed patients may endure surgery or treatment for the wrong diagnosis that can lead to unnecessary harm.
How does Edrophonium differentiate myasthenia gravis from cholinergic crisis?
Edrophonium (by the so-called Tensilon test) is used to differentiate myasthenia gravis from cholinergic crisis and Lambert-Eaton. In myasthenia gravis, the body produces autoantibodies which block, inhibit or destroy nicotinic acetylcholine receptors in the neuromuscular junction.
What are the early signs of cholinergic crisis?
These include cramps, increased salivation, lacrimation, muscular weakness, paralysis, muscular fasciculation, diarrhea, and blurry vision[1][2][3]. In clinical practice, this condition is most commonly seen in: Patients with myasthenia gravis on treatment with high dose acetylcholinesterase inhibitors.
What test should be used to diagnose myasthenia gravis?
Physical exam. Pre-testing (also called bedside testing) includes a complete physical exam.
What tests can help diagnose myasthenia gravis?
Nerve conduction studies (NCS)
Why is myasthenia gravis considered an autoimmune disease?
Myasthenia gravis is an autoimmune disease that causes muscle weakness.
What are the early symptoms of myasthenia gravis?
Visual problems,including drooping eyelids (ptosis) and double vision (diplopia)
