Myasthenia Gravis Clinical Manifestations

Written by Tang Bo
Neurology
Updated on September 01, 2024
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The clinical manifestations of myasthenia gravis include fluctuating weakness of specific striated muscles that is fatigue-prone. Symptoms are generally milder in the morning and worsen by night, increasing after sustained activity and alleviating after rest. Additionally, some patients may experience ocular muscle weakness, presenting with ptosis and diplopia, which could be among the earliest symptoms. Eye movement disorders may occur, preventing the eyes from looking to one side, and pupil abnormalities may be present. Facial muscle weakness can lead to cheek puffing and air leakage, inability to close the eyes, or asymmetry of the mouth, resembling a forced smile. There may also be weakness in the masticatory muscles, leading to difficulties in chewing and swallowing, potential speech impairments, and coughing when drinking water. Neck muscle weakness may manifest as difficulty in lifting the head. Muscle weakness can affect various limbs, primarily proximally, and respiratory muscle weakness can lead to breathing difficulties and dryness.

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Written by Tang Bo
Neurology
1min 19sec home-news-image

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.

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Written by Zhang Hui
Neurology
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Myasthenia gravis belongs to which department?

Myasthenia gravis is an autoimmune disease of the nervous system, primarily affecting the neuromuscular junction where synaptic function is significantly impaired. This disease falls under the purview of neurology, and most neurologists are quite familiar with myasthenia gravis, considering it a common and frequently occurring neurological condition. Patients with myasthenia gravis typically exhibit symptoms such as drooping eyelids, double vision, and general fatigue. They experience a pathological tiredness, feeling extremely exhausted after minor activities, although rest can alleviate symptoms. These symptoms are also commonly associated with the nervous system, so it is appropriate to consult the neurology department. Treatment for patients with myasthenia gravis may involve administering immunoglobulins or corticosteroids, depending on the situation, while also taking precautions to prevent potential complications.

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Written by Zhang Hui
Neurology
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What department is myasthenia gravis under?

Myasthenia gravis, this disease definitely requires registration with the Department of Neurology as it is a relatively common disease in neurology, and doctors in other departments are not particularly familiar with this disease, let alone diagnosis and treatment. Myasthenia gravis is an immune disease of the nervous system, and patients may experience generalized fatigue, which can be alleviated after rest. It is characterized by clinical symptoms that are lighter in the morning and more severe in the evening. Additionally, symptoms such as ptosis, double vision, and even some difficulties in swallowing and unclear speech, known as bulbar paralysis, may occur. This disease requires a thorough chest CT scan, as many patients have an associated thymoma. Furthermore, an electromyography examination is needed to check for antibodies related to myasthenia gravis, which is also important for guiding further treatment.

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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.

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Written by Zhang Hui
Neurology
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What should not be eaten in the case of myasthenia gravis?

Myasthenia gravis is an autoimmune disease of the nervous system, primarily due to dysfunction at the neuromuscular junction, leading to skeletal muscle fatigue. Symptoms include drooping eyelids, double vision, overall weakness, and even swallowing difficulties. Foods that should be avoided in myasthenia gravis mainly include certain medications, such as aminoglycoside antibiotics, which should not be taken orally by patients, as well as fluoroquinolone antibiotics. These antibiotics can exacerbate neuromuscular transmission disorders, potentially worsening the disease. Additionally, benzodiazepines, barbiturates, and some anti-arrhythmic drugs can also reduce muscle membrane excitability and should be avoided.