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Related to myasthenic: Myasthenic crisis


Relating to myasthenia.



Relating to myasthenia.


(mī″ăs-thē′nē-ă) [ my- + -asthenia]
Muscular weakness and abnormal fatigue. myasthenic (-then′ik), adjective

myasthenia gravis

Abbreviation: MG
An autoimmune motor disorder marked by muscular fatigue that develops with repetitive muscle use and improves with rest or with the application of a cold pack. It is caused by antibodies to the acetylcholine receptor in the neuromuscular junction and a decrease in receptor sites for acetylcholine. Because the smallest concentration of acetylcholine receptors in the body is in the cranial nerves, weakness and fatigue of the eye muscles, muscles of mastication, and pharyngeal muscles are the most prominently affected in most patients, but any (skeletal) muscle group may be involved. The disease is rare, affecting about 14 people out of 100,000.


Diagnosis is made on the basis of patient history, a thorough neurological examination, electromyography, repetitive nerve stimulation, a Tensilon test, or a combination of these tests. Intravenous injection of Tensilon significantly improves muscle weakness within 60 sec, lasting up to 30 min Acetylcholinesterase receptor antibody titers in the blood are elevated in about 50% to 70% of patients with myasthenia gravis.


Clinical signs include ptosis of the eyelid and double vision due to fatigue and weakness in the extraocular muscles, and difficulty chewing and swallowing from impaired facial and pharyngeal muscles. Speech that becomes progressively more dysarthric during prolonged dialogue is another common symptom. Symptoms are exacerbated by repetitive muscle use, and, in some patients, by menses, emotional stress, prolonged exposure to sunlight or cold, and infections. Myasthenia gravis crisis is a sudden exacerbation of symptoms with respiratory failure.


The primary treatment is with anticholinesterases and immunosuppressive agents. Anticholinesterase therapy often becomes less effective as the disease worsens. In selected patients, removal of the thymus, plasmapheresis, or immunoglobulin therapy is used.

Patient care

The patient with MG should seek medical attention immediately if he or she experiences difficulty breathing, talking, chewing, or swallowing. These symptoms may herald a myasthenic crisis. In crisis the patient's cardiovascular, neurologic, and respiratory status should be monitored in an intensive care unit. Suctioning the airway and postural changes may sometimes maintain adequate oxygenation and ventilation. If not, the patient will need intubation and positive-pressure ventilation. Exercise, meals, and care activities should be planned around medication-induced energy peaks. The patient should be taught that soft but solid foods are more easily managed than liquids when swallowing is difficult. Additional help for patients is available through support groups and Internet-based resources such as the Myasthenia Gravis Foundation of America (


Because edrophonium (Tensilon) occasionally causes significant bradycardia or asystole, atropine should be kept at the bedside of any patient given this medication.
References in periodicals archive ?
Myopathic EMG findings and type II muscle fiber atrophy in patients with Lambert-Eaton myasthenic syndrome.
Myasthenic crisis with respiratory failure Type IV Tip IV Require intubation Miastenicna kriza sa respiratornom insuficijencijom.
The patients received routine myasthenic drugs on the morning of surgery (Table 1).
After the fifth treatment, he reported his myasthenic symptoms were relieved.
With regard to the reaction time test, the myasthenic group had slower reaction times for each emotion except disgust p < .
Blodau'r teulu agosaf yn unig, ond os dymunir, derbynnir rhoddion yn ddiolchgar tuag at Lambert Eaton Myasthenic Syndrome trwy law'r ymgymerwyr Pritchard a Griffiths Cyf, Heol Dulyn, Tremadog 01766 512091 JONES - TREFOR HAYDN (Hod) 18fed Gorffennaf, 2012.
Approved products include Naglazyme (galsulfase) for mucopolysaccharidosis VI, Kuvan (sapropterin dihydrochloride) for phenylketonuria, Aldurazyme (laronidase) for mucopolysaccharidosis I and Firdapse (amifampridine phosphate) for the treatment of Lambert Eaton Myasthenic Syndrome.
An improved diagnostic assay for Lambert-Eaton myasthenic syndrome.
This study describes a care and rehabilitation model in a patient with Myastenia Gravis (MG) after a myasthenic crisis, in an at-home setting with invasive mechanical ventilation (MV).
Ronnie was born in October 2008 with congenital myasthenic syndrome, a rare genetic disorder robbing him of almost all muscle control and leaving him unable to breathe or swallow naturally.
Selected IgG rapidly induces Lambert-Eaton myasthenic syndrome in mice: complement independence and EMG abnormalities.