Types of myasthenia gravis crisis

Written by Tang Bo
Neurology
Updated on September 13, 2024
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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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Where should I go for treatment of myasthenia gravis?

Myasthenia gravis is classified as a neurology disease. Therefore, patients should visit the neurology department for medical consultation. Fundamentally, it is an immune disorder of the nervous system characterized by the production of abnormal antibodies. These antibodies affect the acetylcholine receptors on the postsynaptic membrane, thereby impacting the transmission of nerve impulses at the neuromuscular junction, which leads to various clinical symptoms. Patients may experience ptosis, double vision, and potentially compromised swallowing function, causing overall weakness. Symptoms typically worsen towards the evening. Many patients also present with thymus abnormalities. Treatment generally involves oral medications, predominantly corticosteroids and cholinesterase inhibitors.

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Written by Tang Bo
Neurology
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myasthenia gravis-related antibodies

Most cases of myasthenia gravis are mediated by acetylcholine receptor antibodies, involving cell-mediated immunity with complement, generally affecting the neuromuscular junction and causing a neuromuscular transmission disorder. This results in an acquired autoimmune disease of muscle weakness. However, a small number of patients with myasthenia gravis are mediated by muscle-specific kinase antibodies or low-density lipoprotein receptor-related protein 4 antibodies. Its main clinical manifestations include skeletal muscle weakness, fatigue, worsening with activity, and significant alleviation or reduction of symptoms after rest and the use of acetylcholinesterase inhibitors. Additionally, the disease can occur at any age, with females being more affected than males before the age of 40. Between 40 and 50 years old, the incidence rates between males and females are comparable, but after 50 years of age, the incidence rate in males is higher than in females.

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Written by Zhang Hui
Neurology
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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.

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Written by Zhang Hui
Neurology
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Myasthenic crisis includes

Myasthenia Gravis, a type of immune inflammatory disease of the nervous system, is mainly caused by the production of abnormal antibodies in the body. Myasthenic crisis can endanger the life safety of patients, affecting respiratory function. There are mainly three types of crises: The first type of crisis is the myasthenic crisis, which is also the most common. Generally, it is caused by the progression of the disease itself, often due to insufficient anticholinesterase drug dosage. The second type of crisis is the cholinergic crisis, caused by an overdose of anticholinesterase drugs, resulting in symptoms like muscle tremors in patients. The third type is the paradoxical crisis, which occurs due to insensitivity to anticholinesterase drugs, leading to severe respiratory difficulties. It is essential to handle a myasthenic crisis promptly, maintain the patient's airway clearance, and use a ventilator for treatment if necessary.

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Written by Liu Hong Mei
Neurology
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Will severe myasthenia gravis swallowing difficulties improve?

Myasthenia gravis and difficulty swallowing generally improve with medication treatment. Myasthenia gravis is a neuromuscular disease that typically presents with worsened muscle weakness and swallowing difficulties during fatigue. This condition requires targeted pharmacological treatment and further repetitive stimulation, which can involve specific medications and steroids. Swallowing difficulties associated with myasthenia gravis are typical of generalized myasthenia gravis, necessitating active pharmaceutical treatment, which usually has good outcomes. Avoid overworking, staying up too late, smoking, and excessive drinking. It is important to rest sufficiently, ensure ample sleep, eat fresh vegetables and fruits, and consume high-protein, nutritious foods.