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Myasthenia Gravis Overview Myasthenia Gravis is an autoimmune disorder of the postsynaptic neuromuscular junction. Ab to
variable degree of weakness ... Limb- proximal weakness ... test - Cogan sign ... - Peek sign ... Severe bulbar weakness
Ocular Myasthenia Gravis on Physical Exam A 41yo female was referred by her neurologist for double vision.
Ocular Myasthenia ... non-localized EOM weakness ... Myasthenia gravis ... such as cogan sign ... eyelid #Ocular #Myasthenia
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 Floppy Baby Syndrome • Infantile Botulism • Acute Flaccid Myelitis • Guillain Barre • Neonatal Myasthenia
Barre • Neonatal Myasthenia ... resistance - Weakness ... LMN signs - Assess
Weakness - Differential Diagnosis Framework Approach To Weakness: • Non-neuromuscular disorder (Cardiac, pulmonary etc) • CNS ->
Weakness - Differential ... Approach To Weakness ... Muscle • Muscle weakness ... Postsynaptic: Myasthenia ... Lack of UMN/LMN signs
Myasthenia Gravis - Ptosis, Diplopia, Blurred Vision Acute Myasthenic Crisis • Triggered by infection, medication • Respiratory
Myasthenia Gravis ... Vision Acute Myasthenic ... ventilation #Myasthenia
Causes of Peripheral Weakness without Sensory Changes - Differential Diagnosis Algorithm No Objective Weakness • Cardio-pulmonary disease
of Peripheral Weakness ... No Objective Weakness ... Oculomotor • Myasthenia ... Lambert-Eaton Myasthenic ... #Peripheral #Weakness
Drugs associated with worsening of Myasthenia Gravis (MG): • D-penicillamine • Botulinum toxin. • Telithromycin • Fluoroquinolones • Quinine • Magnesium • Macrolide antibiotics • Corticosteroids (may cause transient
with worsening of Myasthenia ... prevent prolonged myasthenic ... higher risk of myasthenic ... because of bulbar weakness
Myelopathy - Injury to the entire spinal cord - Signs and Symptoms • Ataxia (early sign)
spinal cord - Signs ... Ataxia (early sign ... • Gross motor weakness ... (late sign) • ... dexterity loss (early signs
Myasthenia Gravis - Summary • an autoimmune disease of the postsynaptic neuromuscular junction associated with antibodies
Myasthenia Gravis ... or respiratory weakness ... mild to moderate weakness ... or generalized weakness ... and in myasthenic
Myasthenia Gravis Signs, Symptoms and Testing - Likelihood Ratios Does this patient have myasthenia gravis? JAMA. 2005 Apr 20;293(15):1906-14.
Myasthenia Gravis ... Signs, Symptoms ... this patient have myasthenia ... #Diagnosis #Myasthenia
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