Myasthenia Gravis

Last Updated on by frcemuser

  • Autoantibodies are formed which bind to acetylcholine receptors on skeletal muscle.
  • Anti-acetylcholine antibodies impair transmission at the neuromuscular junction
  • Symptoms and sings: ptosis, diplopia, dysarthria (speech disorder), dysphagia (difficulty swallowing), facial paresis, proximal limb weakness, and shortness of breath
  • Management
    • Acetylcholinesterase inhibitors (e.g. pyridostigmine)
    • Plasmapheresis may directly remove auto-antibodies.
    • Immunosuppressive therapies are aimed at reduction in the synthesis of auto-antibodies
    • Indication for mechanical ventilation includes forced vital capacity (FVC) 15 mL/kg or less (normal ≥60 mL/kg) and negative inspiratory force (NIF) 20 cm H2O or less (normal ≥70 cm H2O).

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