Types of Myasthenia Gravis Crisis

Written by Zhang Hui
Neurology
Updated on September 17, 2024
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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.

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Written by Zhang Hui
Neurology
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Is it dangerous to have a fever with myasthenia gravis?

Myasthenia gravis is a disease of the neuromuscular junction, essentially an autoimmune inflammatory response that causes generalized weakness and fatigue of the skeletal muscles, with symptoms that are less severe in the morning and worsen by the evening, and fluctuate over time. The weakness can be alleviated by rest. When patients with myasthenia gravis develop a fever, it is generally considered to be caused by an infection, perhaps a viral infection such as an upper respiratory tract infection, which can also induce fever. In such cases, the main treatment involves drinking plenty of water and consuming fresh vegetables and fruits. If necessary, some antiviral medications and antipyretics may be administered. If the fever is due to a bacterial infection, symptomatic treatment should be accompanied by the appropriate antibiotics. However, the choice of antibiotics must be made with caution. Patients with myasthenia gravis should not use aminoglycosides or fluoroquinolones, as these could exacerbate their condition. Penicillins or cephalosporins may be used instead. (Please consult a professional physician for specific medication guidance.)

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Written by Tang Bo
Neurology
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Myasthenia gravis initial symptoms

Myasthenia gravis is characterized by fluctuating and fatigue-prone muscle weakness in certain specific striated muscles. Symptoms are generally milder in the morning and more severe in the evening, worsening with continued activity and alleviating after rest. The most common initial symptom is weakness of the external eye muscles, primarily presenting as asymmetrical ptosis (drooping of the upper eyelid) or narrowing of the eye slit, along with diplopia, which refers to seeing double images. These are the most frequent initial symptoms, seen in over 50% of patients with myasthenia gravis. Additionally, some patients may experience disturbances in eye movement, facial muscle weakness, air leakage when puffing cheeks, incomplete eyelid closure, shallower nasolabial folds, as well as difficulty swallowing, speech articulation issues, choking while drinking, and potentially severe respiratory weakness.

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Written by Zhang Hui
Neurology
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How to alleviate myasthenia gravis?

Myasthenia gravis is a disease of the department of neurology and its incidence is not low, it is also relatively common clinically. The treatment of myasthenia gravis mainly includes the following points: First, if patients with myasthenia gravis also have a thymoma, it is recommended to surgically remove the thymoma as soon as possible, which can significantly alleviate the symptoms of myasthenia gravis and reduce the amount of medication needed. Second, provide patients with some medication, mainly some drugs that suppress the immune response, including some corticosteroids. The use of corticosteroids is relatively complex, and must be gradually increased or decreased under the advice of a doctor. Do not stop taking them on your own. There are also some drugs that are cholinesterase inhibitors, which can increase the content of acetylcholine in the synaptic gap, alleviating the patient's symptoms. In addition, research has confirmed that some new immunosuppressive agents can also be used in the treatment of myasthenia gravis. In summary, the treatment of myasthenia gravis is a comprehensive subject and must be tailored according to the patient's condition.

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Written by Liu Yan Hao
Neurology
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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.

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Written by Zhang Hui
Neurology
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Does myasthenia gravis require hospitalization?

Myasthenia Gravis is a type of neuroimmune disease within the field of neurology which fundamentally stems from issues with the patient's own immune function. Whether hospitalization is necessary depends critically on the severity of the disease. If Myasthenia Gravis manifests only as ocular symptoms, such as ptosis and double vision, hospitalization is generally not necessary. It is important to take certain medications, primarily cholinesterase inhibitors and corticosteroids, but regular outpatient follow-ups are essential. However, if Myasthenia Gravis is generalized, with noticeable whole-body weakness, particularly if accompanied by swallowing difficulties and coughing while drinking, hospitalization is required. If a myasthenic crisis occurs, presenting with respiratory muscle weakness and breathing difficulties, hospitalization is certainly needed, and admission to the ICU might be necessary.