Review Article MYASTHENIA GRAVIS
Keywords:
Neuromuscular junction, Autoimmune disease, ThymusAbstract
Myasthenia gravis is a neuromuscular junction disease characterized by severe muscle weakness. It commonly involves muscles of the eye, face and swallowing. In severe cases, respiratory muscles may be affected. It is an autoimmune disease in which antibodies against acetylcholine nicotinic receptors are formed, which destroy these receptors. Thymus is enlarged in many of these patients. These patients are managed by acetylcholine esterase inhibitors (neostigmine), immunosuppression by cortisol and plasmapheresis. Thymectomy is effective in some cases.
References
Sclerosis AL. Fact Sheet| National Institute of Neurological Disorders and Stroke; 2019.
Ehrlich A, Schroeder CL, Ehrlich L, Schroeder KA. Medical Terminology for Health Professions, Spiral bound Version. Cengage Learning; 2021 Aug 4.
Kaminski HJ, Kusner LL, editors. Myasthenia gravis and related disorders. Humana press; 2018 Mar 13.
doi10.1007/978-1-59745-156-7
Adams JG. Emergency medicine E-book: clinical essentials (expert consult--online). Elsevier Health Sciences; 2012 Sep 5.
Young C, McGill SC. Rituximab for the Treatment of Myasthenia Gravis: A 2021 Update. Canadian Journal of Health Technologies. 2021 Apr 15;1(4). Available from: https://www.ncbi.nlm.nih.gov/books/NBK571915/
Trouth AJ, Dabi A, Solieman N, Kurukumbi M, Kalyanam J. Myasthenia gravis: A review. Autoimmune Diseases. 2012;1(1):874680. https://doi.org/10.1155/2012/874680
Phillips WD, Vincent A. Pathogenesis of myasthenia gravis: update on disease types, models, and mechanisms. F1000Research. 2016;5.
doi:10.12688/f1000research.8206.1.
Sathasivam S. Diagnosis and management of myasthenia gravis. Progress in Neurology and Psychiatry. 2014 Jan;18(1):6-14.
doi:10.1002/pnp.315. S2CID 115659064.
Nair AG, Patil-Chhablani P, Venkatramani DV, Gandhi RA. Ocular myasthenia gravis: a review. Indian journal of ophthalmology. 2014 Oct;62(10):985.
doi:10.4103/0301-4738.145987.
Scully C. Scully's Medical Problems in Dentistry E-Book. Elsevier Health Sciences; 2014 Jul 21.
Engel AG, editor. Myasthenia gravis and myasthenic disorders. OUP USA; 2012 Apr 3.
Scherer K, Bedlack RS, Simel DL. Does this patient have myasthenia gravis?. Jama. 2005 Apr 20;293(15):1906-14.
doi:10.1001/jama.293.15.1906. PMID 15840866.
Marx JA, Hockberger RS, Walls RM. Rosen's Emergency Medicine: Concepts and Clinical Practice (Volume 2). Elsevier; 2010.
Helman G, Van Haren K, Bonkowsky JL, Bernard G, Pizzino A, Braverman N, et al. GLIA Consortium. Disease specific therapies in leukodystrophies and leukoencephalopathies. Mol Genet Metab. 2015 Apr;114(4):527-36. doi: 10.1016/j.ymgme.
Warnecke T, Im S, Labeit B, Zwolinskaya O, Suntrup-Krüger S, Oelenberg S, Ahring S, Schilling M, Meuth S, Melzer N, Wiendl H. Detecting myasthenia gravis as a cause of unclear dysphagia with an endoscopic tensilon test. Therapeutic Advances in Neurological Disorders. 2021 Aug;14:17562864211035544.
Mehndiratta MM, Pandey S, Kuntzer T. Acetylcholinesterase inhibitor treatment for myasthenia gravis. Cochrane Database of Systematic Reviews. 2014(10). doi:10.1002/14651858.CD006986.
Mehndiratta MM, Pandey S, Kuntzer T. Acetylcholinesterase inhibitor treatment for myasthenia gravis. Cochrane Database of Systematic Reviews. 2014(10).
doi:10.1002/14651858.
Kumar V, Kaminski HJ. Treatment of myasthenia gravis. Current neurology and neuroscience reports. 2011 Feb;11(1):89-96.
doi:10.1007/s11910-010-0151-1.
Voelker R. A New Option Is Approved for Patients With Myasthenia Gravis. JAMA. 2022 Feb 1;327(5):417. doi:10.1001/jama.2022.0177
Cea G, Benatar M, Verdugo RJ, Salinas RA. Thymectomy for non‐thymomatous myasthenia gravis. Cochrane Database of Systematic Reviews. 2013(10).CD008111.
doi:10.1002/14651858.
Wolfe GI, Kaminski HJ, Aban IB, Minisman G, Kuo HC, Marx A, Ströbel P, Mazia C, Oger J, Cea JG, Heckmann JM. Randomized trial of thymectomy in myasthenia gravis. New England Journal of Medicine. 2016 Aug 11;375(6):511-22.
doi:10.1056/NEJMoa1602489.
Sieb JP. Myasthenia gravis: an update for the clinician. Clinical & Experimental Immunology. 2014 Mar;175(3):408-18.
doi:10.1111/cei.12217.
Cup EH, Pieterse AJ, Ten Broek-Pastoor JM, Munneke M, van Engelen BG, Hendricks HT, van der Wilt GJ, Oostendorp RA (November 2007). "Exercise therapy and other types of physical therapy for patients with neuromuscular diseases: a systematic review". Archives of Physical Medicine and Rehabilitation. 88 (11): 1452–1464.
doi:10.1016/j.apmr.2007.07.024.