Myastheniacrisis

You might also like

Download as pptx, pdf, or txt
Download as pptx, pdf, or txt
You are on page 1of 1

ANNUAL SCIENTIFIC PROGRAM, 2022

AIIMS PATNA

Reg no. Myasthenia Gravis: Difficult to Suspect, Easy to Diagnose and Challenging to Treat
JR-05
Dr Chandrima Pattadar, Dr Divendu Bhushan, Dr Vijay Kumar, Dr Sanjeev Kumar, Dr
Poonam Bhadani : Department of General Medicine
HIGHLIGHTS CASE REPORT CONCLUSION
• Respiratory failure Suspect myasthenia gravis
18 years female, presented with sudden onset shortness of breath, and was intubated in
without lung if patient has episodic
emergency.
involvement may be a weakness,
case of myasthenia Fig 1: CXR- Fig 2: CECT chest
PA:Smooth well respiratory distress , ptosis,
crisis. showing well defined
• Myasthenia gravis with marginated soft soft tissue with dysphagia. Screen for
thymoma patient may mass in smooth margin in thymoma as its presence
have better prognosis mediastinum,insep anterior influence the prognosis of
if thymectomy done arable from right mediastinum-likely patient. Complete remission
early.
INTRODUCTION cardiac silhouette thymoma. is seen in only 20%
Myasthenia gravis is an She was having similar episodes in past but those improved with medicines (steroids). To rule patients.
autoimmune disease of REFERENCES
out Myasthenia gravis, Neostigmine challenge test done which was positive. She was given • Gilhus NE. Myasthenia Gravis. N
neuromuscular junction IVIG along with prednisolone, extubated in 3 days. Her Anti Ach antibodies were strongly Engl J Med, 2016; 375(26): 2570–81
causing episodic positive. later thymectomy was done. She was discharged on steroids, pyridostigmine and • Bird SJ: Overview of the treatment of
myasthenia gravis. UpToDate, 2020
weakness, involving mycophenolate mofetil. • StetefeldH, SchroeterM:SOP
skeletal muscles. DISCUSSION myasthenic-crisis. Neurological
Among them 15-20% Research,2019; 1(1): 19
Hallmark clinical presentation of myasthenia gravis is weakness, but its initial presentation • Spillane J, Higham E:Easily missed?
patient may present with Myasthenia gravis. BMJ, 2013; 19:
may be shortness of breath(myasthenia crisis) which required ventilatory support to prevent
myasthenia crisis. On 36–38
death, cause mortality is 16%.In the presented case, precipitating factor was inadequate • Wendell LC, Levine JM. Myasthenic
proper treatment,20% treatment, this report signifies importance of differential diagnosis of myasthenia crisis when crisis. Neurohospitalist. (2011) 1:16–
patient got cured patient presented with respiratory distress without neurological or pulmonary involvement. 22. doi: 10.1177/1941875210382918
successfully. .

You might also like