Tag: Myasthenia gravis

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Can myasthenia gravis patients take diazepam drugs?

Almost all the instructions for diazepam drugs will say [myasthenia gravis patients are forbidden or used with caution]! Due to the muscle relaxation effect of diazepam drugs, In theory and practice, it does partially aggravate the symptoms of myasthenia gravis patients’ myasthenia, and even worsen respiratory function in patients with dyspnea. However, nothing in clinical practice is absolute, otherwise it becomes mechanical [scripted] and cannot actually help patients solve the problem. Therefore, all kinds of clinical problems are actually relative! If the patient has significant anxiety and sleep disorders, It will also significantly aggravate the condition of myasthenia gravis patients, If the patient can use diazepam drugs under the doctor’s evaluation and follow-up. For example, patients in pre-crisis or crisis Read More …

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Increased risk of osteoporosis in young myasthenia gravis patients

Is the risk of osteoporosis increased in myasthenia gravis patients compared with normal people? Let’s take a look at the hints of the recent study of two large samples. There was no statistical difference in the probability of fractures or osteoporosis-related fractures in patients with myasthenia gravis A British study published in 2013 conducted a retrospective cohort study of 1066 myasthenia gravis patients from 1987 to 2009, with age and sex-based controls. The results showed that the probability of fracture or osteoporosis-related fracture in myasthenia gravis patients showed no statistical difference compared with the control group, and their adjusted risk ratios (AHR) were 1.11 and 0.98 respectively. In addition, among myasthenia gravis patients, those who used oral glucocorticoid more than Read More …

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Precautions for Myasthenia Gravis Crisis

First solve the ventilation problem Although myasthenia gravis crisis includes cholinergic crisis, myasthenia crisis and antagonistic crisis, it is often difficult to accurately identify them in clinical work. In any case, rapid improvement of patient ventilation is the primary task to solve the crisis. Early patients show more prominent carbon dioxide retention than hypoxemia. Therefore, we should not rely on the oxygen saturation monitoring value on the monitor, but should closely follow up the arterial blood gas. If there is typical type II respiratory failure, we should give mask balloon assisted ventilation in case of emergency, followed by tracheal intubation/tracheotomy and artificial respiration assisted respiration immediately. Attention should be paid to frequent lung auscultation and examination of cannula position. In Read More …

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Occurrence and treatment of myasthenia gravis

Autoantibodies Lead to Abnormal Transmission of Neuromuscular Junction The human body must rely on the normal neuromuscular junction transmission process (shown in the question figure) when completing each skeletal muscle contraction activity. The neuromuscular junction consists of (1) (presynaptic motor nerve endings), (2) (postsynaptic muscle cell membrane) and the synaptic gap between the two. When a motor command is transmitted from (1), It will activate ③ (synaptic vesicles) to release the chemical transmitter acetylcholine into synaptic spaces, and when acetylcholine moves to ② (postsynaptic muscle cell membrane) through the spaces, it will combine with ④ (acetylcholine receptor) above to further activate ⑤ (mitochondria in muscle cells), thus completing muscle contraction and executing movement instructions. The cause of myasthenia gravis lies Read More …

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Neonatal transient myasthenia gravis and childhood myasthenia gravis

Neonatal transient myasthenia gravis First of all, it is clear that myasthenia gravis is impossible for newborns delivered by non-myasthenia gravis mothers, because myasthenia gravis is an autoimmune disease and is related to the abnormality of the immune system. The immune system of newborns is not fully developed. How can myasthenia gravis occur? Therefore, myasthenia gravis does not need to be listed as the category of differential diagnosis for children with ptosis or abnormal eyeball movement immediately after delivery by healthy mothers. In theory, Neonatal transient myasthenia gravis exists, It can be caused by the anti-AChR antibody in the serum of the sick mother being transferred into the fetus through the placenta, The neonates showed difficulty in feeding, hypotonia, low Read More …

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Pregnancy, Delivery and Lactation in Patients with Myasthenia Gravis

Myasthenia gravis is not a contraindication of pregnancy. The condition of sick women varies during pregnancy and may improve, worsen or stabilize. The condition is more likely to worsen in the first 3 months of pregnancy, while the condition is more likely to worsen in the last 3 months of second pregnancy and postpartum. However, myasthenia gravis is not a contraindication of pregnancy. Spontaneous abortion caused by myasthenia gravis is rare. Cholinesterase inhibitors and prednisone are safe for the fetus. At present, there is no evidence that pregnant women taking large doses of prednisone will have adverse effects on their infants. Azathioprine, cyclophosphamide, etc. may have teratogenic effects and must be stopped before pregnancy. Although there is no large-scale clinical Read More …

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Precautions for surgery and anesthesia in myasthenia gravis patients

Precautions for surgery in patients with myasthenia gravis As it is a rare disease, Many hospitals have to ask neurology consultation to determine the surgical indications and anesthesia methods after surgical treatment of myasthenia gravis patients with patients requiring surgery. In fact, the basic principle of clinical medicine is to [solve the main contradiction at present], If the patient’s surgery is imminent, Such as intestinal obstruction or spleen rupture, No matter what happened to the previous myasthenia gravis, emergency surgery is required. Even if the operation will aggravate myasthenia gravis, there is no need to worry about it. Because if the current surgical situation is not handled in time, it will endanger life. Therefore, emergency surgery for myasthenia gravis patients Read More …

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Problems related to ocular muscles in myasthenia gravis patients

Why is the levator palpebrae muscle of myasthenia gravis patients most vulnerable? The first common symptom of myasthenia gravis patients is ptosis, But its mechanism is not clear. Some scholars believe that the levator palpebrae superior muscle is different from other extraocular muscles. For fast shrinkage fibers, It has a high anti-fatigue property and is a muscle fiber that is not innervated by multiple nerves. The levator palpebrae superior muscle has been stimulated by nerve impulses when opening eyes, so its compensation space is small under pathological conditions, and the [reserve] to deal with pathological changes is insufficient, resulting in the safety factor of neuromuscular transmission being easily affected and more easily fatigued than other muscles. Some studies have also Read More …

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Precautions for Several Major Drugs in Myasthenia Gravis Patients

Statins and Myasthenia Gravis 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor) have that effect of reducing blood lipid and anti-inflammation, It can reduce the incidence of cerebrovascular diseases and coronary heart disease. In the past 10 years, the application of statins has increased significantly. Although most patients are generally well tolerated to statins, the drugs still have certain side effects, such as myalgia and rhabdomyolysis in severe cases. In theory, Statins may induce or aggravate myasthenia gravis symptoms, However, it is not caused by affecting the transmission of neuromuscular junctions. Pharmacological mechanism studies have found that, Statins can inhibit T cell activation, Inducing the transformation of helper T (Th) cells to Th2 cells, acting on B cells Read More …

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Is myasthenia gravis related to thymus what?

Thymus is located in the anterior mediastinum of the thoracic cavity behind the sternum. It is an important lymphoid organ of the human body. Its function is closely related to immunity. During the late embryo and birth, the human thymus weighs about 10-15g. With the growth of age, the thymus continues to develop and reaches puberty about 30-40g. After that, the thymus gradually degenerates, lymphocytes decrease, adipose tissue increases, and only 15g is reached in the elderly. According to incomplete clinical statistics, 90% of myasthenia gravis patients have thymus abnormalities, about 70% have thymus hyperplasia and 10-15% have thymoma. Some patients have obvious improvement of symptoms and obvious decrease of AChR antibody titer after thymectomy, which all indicate that thymus Read More …