RT Book, Section
A1 Singh, Manpreet
A1 Whitfield, Denise
A2 Knoop, Kevin J.
A2 Stack, Lawrence B.
A2 Storrow, Alan B.
A2 Thurman, R. Jason
SR Print(0)
ID 1181038491
T1 Myasthenia Gravis
T2 The Atlas of Emergency Medicine, 5e
YR 2021
FD 2021
PB McGraw-Hill
PP New York, NY
SN 9781260134940
LK accessmedicine.mhmedical.com/content.aspx?aid=1181038491
RD 2024/04/18
AB Myasthenia  gravis  is  an  autoimmune  disorder  of  neuromuscular  transmission  that  results  in  weakness  of  multiple  muscle  groups.  The  disease  is  antibody-mediated  with  a  T-cell–modulated  attack  on  postsynaptic  acetylcholine  receptors  at  the  neuromuscular  junction.  The  two  clinical  presentations  of  myasthenia  gravis  are  ocular  and  generalized  disease.  In  ocular  disease,  weakness  is  limited  to  the  eyelids  and  extraocular  muscles,  whereas  in  generalized  disease,  bulbar  (eg,  dysarthria,  dysphagia),  limb,  and  respiratory  muscles  may  be  involved  in  addition  to  the  eyes.  More  than  half  of  myasthenia  gravis  patients  present  with  ptosis  and/or  diplopia.  Ptosis  can  alternate  from  eye  to  eye  with  severity  waxing  and  waning.  Extraocular  muscle  weakness  may  manifest  as  binocular  diplopia,  with  early  symptoms  presenting  simply  as  blurry  vision.  The  pupils  are  always  spared  in  myasthenia  gravis,  differentiating  it  from  other  extraocular  movement  disorders.