"INTERNAL MEDICINE"

What is Myasthenia Gravis?
It is an autoimmune disorder of neuromuscular junction(NMJ) resulting in decrease in muscle power and easy fatiguability.

What is its incidence?
It is more common in women as compared to men,mostly before 30 yrs of age.

What are the other causes of Myasthenia Crisis?
Aminoglycosides,D penicillamine and Infections can lead to Myasthenia crisis.

What are the sign and symptoms ?
It results in muscular weakness and fatiguability.Most common groups of muscles involved are ocular,muscles of mastication,speech and proximal muscles.
Respiratory muscles involved can lead to respiratory paralysis.
Ocular muscles paralysis results in Diplopia and extraocular in ptosis.

How is it diagnosed?
Basically a clinical diagnosis but few other investigations can be helpful like
Choline receptor specific antibodies,Tensilon test(Edrophonium),Chest X ray,CT scan and MRI chest.
Blood CP and other biochemical profile is normal however RA factor and ANA are raised.

There is not much role of Muscular Biopsy.

How is it managed?
DRUGS:
Pyridostigmine 60 mg 3 to 4 times daily is used to improve the muscular weakness.

Steroids and Azathiopurine are the drugs used for immunosuppression.

THYMECTOMY.

PLASMAPHERESIS.