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neurology causes ophthalmology algorithm ocular physicalexam acetylcholinereceptor achr clinical doublevision endocrinology eyelid hyperthyroidism intravenousimmunoglobulin ivig management maneuvers musclespecificreceptortyrosinekinase musk myastheniagravis
Myasthenia Gravis Overview Myasthenia Gravis is an autoimmune disorder of the postsynaptic neuromuscular junction. Ab to
Myasthenia Gravis ... Ocular- 50%: Ptosis ... , diplopia 2. ... chewing, loss of smile ... #Gravis #diagnosis
Diagnosis of Myasthenia Gravis - Physical Exam Maneuvers • Sustained lateral gaze for seconds to elicit
Diagnosis of Myasthenia ... Gravis - Physical ... elicit fatigable diplopia ... • Lifting the ptotic ... #Gravis #PhysicalExam
Diplopia - Double Vision - Differential Diagnosis Algorithm Clinical Pearls: • Diplopia is almost always binocular. •
Vision - Differential ... • Look for ptosis ... • Myasthenia ... Gravis is fatiguable ... depressed, abducted, ptosis
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 ... Gravis (MG): • ... because of bulbar weakness ... ocularmyasthenia #ptosis ... #diplopia #myastheniccrisis
Ocular Myasthenia Gravis on Physical Exam A 41yo female was referred by her neurologist for double vision.
non-localized EOM weakness ... and bilateral ptosis ... Myasthenia gravis ... subsequently improved the diplopia ... #clinical #video
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 Causes of Peripheral Weakness without Sensory Changes - Differential Diagnosis Algorithm No Objective Weakness • Cardio-pulmonary disease
Sensory Changes - Differential ... Diagnosis Algorithm ... • Cardio-pulmonary ... Gravis • Lambert-Eaton ... Myasthenic Syndrome
Ptosis - Differential Diagnosis Framework Ptosis (Greek- to fall) Drooping of the upper eyelid that usually results
Ptosis - Differential ... Myasthenia gravis ... and weakness of ... gravis • Botulinum ... gravis • Ocular
Causes of Neuromuscular Weakness • Spinal Cord: Demyelinating Disease (MS), Epidural abscess, Infarction, Syringomyelia, Tetanus, Transverse
Demyelinating Disease (MS ... Eaton Syndrome, Myasthenia ... Gravis, Organophosphate ... #Causes #differential ... #diagnosis #neurology
Weakness - Differential Diagnosis Framework Approach To Weakness: • Non-neuromuscular disorder (Cardiac, pulmonary etc) • CNS ->
Weakness - Differential ... Diagnosis Framework ... Non-neuromuscular disorder (Cardiac ... Postsynaptic: Myasthenia ... Gravis - Lack
Hyperthyroidism Overview Clinical Manifestation of Hyperthyroidism: • Fatigue • Weight loss • Heat intolerance • Depression, nervousness
irregularities • Weakness ... diffuse goiter (Graves ... Cardiac arrhythmia ... orbital edema, diplopia ... #differential #
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