DR Medhat MRCP

Pricipitating factors of myasthenia crisis :
1. The most common is exertion (halmark of MG)
2. Intercurrent infections .
3. Pregnancy.
4. Menses.
5. Drugs : e.g Ca-ch. Blockers )
كباب زي الفل
Beta blockers
Aminoglycosides(gentamycin)
Procainamide,quinidine
Penicillamine
Phenytoin
Lithium
Investigations :
1. Tensilon test : IV Edrophonium reduces muscle weakness temporarily.
2. Anti-acetyle choline receptors antibodies*.
3. CT thorax to exclude thymoma.
4. CK normal
Managment :
long-acting anticholinesterase e.g. Pyridostigmine
Immunosuppression: prednisolone initially
Thymectomy
Management of myasthenic crisis
‏)سؤال هام جدا جدا
‣ Plasmapheresis.
‣ Intravenous immunoglobulins
Very important as the patient may die
from respiratory muscles affection
*antibodies are less commonly seen in disease limited to the ocular muscles
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