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Myasthenia Gravis
What is a good medicine to take for myasthenia gravis?
Myasthenia gravis is an autoimmune disease of the nervous system. Patients need to take medication for a long time, otherwise, antibodies to acetylcholine receptors might continue to be produced, further worsening the clinical manifestations. The medications taken by patients with myasthenia gravis mainly include the following types, the first being cholinesterase inhibitors. These drugs can inhibit the breakdown of acetylcholine by cholinesterase, thereby improving the transmission function between nerve and muscle junctions, and improving the clinical symptoms of patients. It is best to take these medications before meals for better absorption. The second type of medication mainly includes corticosteroids. They can suppress the body's immune response and reduce the production of antibodies, which is very helpful for the recovery from the disease. Long-term usage and gradual dosage reduction are necessary. Additionally, some immunosuppressants need to be taken. Taking these immunosuppressants also aims to suppress the immune response. However, it is essential to be aware of their adverse effects, such as suppression of bone marrow function, and damage to liver and kidney functions.
Can myasthenia gravis be cured completely?
Myasthenia gravis is a relatively common disease in neurology. Whether it can be completely cured mainly depends on the severity of the disease and some of its subtypes. For instance, patients with ocular myasthenia gravis only exhibit symptoms such as ptosis; by using some corticosteroids or acetylcholinesterase inhibitors, some patients can be cured. However, there are also patients who experience generalized muscle weakness, which is particularly severe and may even affect the respiratory muscles. These patients need long-term or even lifelong medication to prevent the recurrence of severe myasthenia gravis. Additionally, some patients with myasthenia gravis also have thymomas, and many patients can be cured after the removal of the thymoma. Therefore, most cases of myasthenia gravis cannot be completely cured and require long-term medication, though a small portion might be curable.
Types of Myasthenia Gravis Crisis
Myasthenia gravis is a neurological disease. It is an autoimmune disorder primarily affecting the neuromuscular junction, leading to symptoms such as pathological fatigue, ptosis, and limb weakness. Myasthenia gravis is termed as such due to its severe nature, including crises that can impair respiratory muscles, leading to respiratory paralysis, respiratory failure, and potentially death. There are three main types of myasthenic crises. The first type is myasthenic crisis, primarily caused by insufficient medication; muscular injections can be used for treatment, and if effective, it indicates a myasthenic crisis. The second type is called cholinergic crisis, resulting from an overdose of acetylcholinesterase inhibitors, with symptoms including muscular twitching and pupil constriction. The third type is called refractory crisis, occurring when the body is insensitive to medication treatments. All these crises pose a life-threatening risk to patients and require immediate management, including tracheal intubation and, if necessary, mechanical ventilation.
What is myasthenia gravis?
Myasthenia gravis is a group of neuromuscular junction disorders and is also an autoimmune disease of the nervous system. It primarily involves the production of certain antibodies in the body that attack the acetylcholine receptors on the postsynaptic membrane of the neuromuscular junction. This results in the inability of nerve impulses to be effectively transmitted to the muscles, causing the muscles to lose neural control, leading to weakness of the limbs. This weakness is typically more pronounced in the evening than in the morning, with symptoms being lighter upon waking and worsening in the afternoon. As the disease is caused by an autoimmune response, a major focus of treatment is to suppress this abnormal immune reaction, primarily through the administration of corticosteroids. Additionally, many patients with myasthenia gravis also exhibit thymus abnormalities, necessitating thorough CT examinations of the thymus.
Myasthenia gravis should not use what medicine?
Myasthenia gravis is a neuromuscular junction disease in neurology, primarily due to some synaptic dysfunction, leading to pathological fatigue and general weakness in patients. Patients with myasthenia gravis often experience exacerbation of the disease due to fatigue or infection, and certain medications can severely affect synaptic function, worsening the condition, and are therefore not to be used. The medications to avoid mainly include the following types: The first type is aminoglycoside antibiotics, which can exacerbate the transmission at the neuromuscular junction. Second, quinolone antibiotics should also be avoided as much as possible. Third, some antiarrhythmic drugs can also decrease the excitability of the fascia and are not recommended. Additionally, some drugs like morphine, benzodiazepines, and receptor blockers should also be contraindicated or used with caution.
How is myasthenia gravis diagnosed?
Myasthenia gravis is essentially an immunoreactive disease in neurology, primarily caused by immune dysfunction in the body, leading to the production of autoantibodies. These antibodies attack the acetylcholine receptors on the postsynaptic membrane, resulting in corresponding clinical symptoms such as ptosis, diplopia, and general fatigue. The examination of myasthenia gravis mainly includes the following aspects: first, the completion of the Tensilon test, and if the test is positive, myasthenia gravis should be considered; second, the examination should include repetitive nerve stimulation electromyography, and if there is a significant decrement in wave amplitude, this disease should be considered; third, relevant blood tests should be conducted, mainly to check for acetylcholine receptor antibodies, as positive results for these antibodies are important in supporting this diagnosis.
Myasthenia Gravis Test Items
Myasthenia gravis is a common neurological disease, primarily an autoimmune disorder. It typically results in symptoms that are worse in the evening and fluctuate throughout the day, mainly manifesting as limb weakness, double vision, swallowing difficulties, and speech impairments. In severe cases, it can even affect respiration, leading to weakness of the respiratory muscles and necessitating the assistance of a ventilator. The key examinations for myasthenia gravis include: Firstly, a chest CT scan. Many patients with myasthenia gravis have thymic hyperplasia or thymomas, making this scan crucial. Secondly, repetitive nerve stimulation electromyography. This test can detect amplitude decrement in response to stimulation, which is significant for diagnosing the disease. Thirdly, testing for specific antibodies related to myasthenia gravis, such as acetylcholine receptor antibodies. The presence of these antibodies is very important for diagnosis. Additionally, other tests such as erythrocyte sedimentation rate and thyroid function tests are also conducted.
Early symptoms of myasthenia gravis
Myasthenia gravis is an autoimmune disease of the nervous system that primarily affects the acetylcholine receptors on the postsynaptic membrane, causing muscle fatigue in patients. This can lead to general weakness throughout the body, double vision, and even progressive paralysis of the respiratory muscles, requiring active breathing assistance in severe cases. The early symptoms of myasthenia gravis mainly include: First, patients tend to fatigue easily, such as after exercise or labor, with a rapid decline in physical strength that only recovers after resting. Second, there may be ptosis, with patients unable to comfortably open their eyes, although this symptom can improve after resting or sleeping. As myasthenia gravis progresses into its later stages, there is a marked increase in overall weakness, necessitating treatment in a neurology department.
Does myasthenia gravis hurt?
Myasthenia gravis does not cause pain. Initially, patients with myasthenia gravis may feel discomfort such as soreness or swelling in the eyes or limbs, blurred vision, or fatigue. As the condition progresses, skeletal muscles become noticeably fatigued and weak. A significant characteristic is muscle weakness, which worsens after exertion in the afternoon or evening and improves after rest in the morning, known as "morning better, evening worse." Patients with myasthenia gravis can experience involvement of skeletal muscles throughout the body, manifesting as drooping eyelids, blurred vision, double vision, strabismus, restricted eye movements, bland facial expressions, a "forced smile" appearance, speech impairments resembling a thick tongue often accompanied by a nasal sound. Additionally, they may have chewing difficulties, coughing or choking when drinking, swallowing difficulties, trouble raising the head, weak shoulder shrugging, difficulty lifting arms, combing hair, climbing stairs, squatting, and getting into vehicles, primarily due to muscle weakness, which does not lead to pain.
Types of myasthenia gravis crisis
Myasthenic crises are categorized into three types, all resulting from worsening conditions or improper treatment, leading to respiratory muscle weakness or paralysis and subsequent difficulty in breathing. The first type occurs due to various triggers or reduction in medication, or after the application of acetylcholinesterase inhibitors which temporarily alleviate the crisis, known as the cholinergic crisis. The second type is a result of excessive use of acetylcholinesterase inhibitors during a cholinergic crisis. Beyond respiratory difficulties, symptoms may also include signs of toxicity such as vomiting, abdominal pain, diarrhea, pupil constriction, excessive sweating, drooling, increased tracheal secretions, and potential muscle tremors, spasms, as well as anxiety, insomnia, confusion, seizures, and coma. The third type is the paradoxical crisis, where neither ceasing nor increasing medication doses alleviates the symptoms, typically occurring after long-term, high-dose medication use.