Myasthenia gravis natural history, complications and prognosis: Difference between revisions
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==Natural History== | ==Natural History== | ||
The [[age of onset]] in Myasthenia gravis follows a bimodal distribution. The early type (before age of 50) is [[female]] predominant and the late type (after age of 60) is [[male]] predominant. Between the age of 50-60 there is no significant different between [[male]] and [[female]].<ref name="pmid23893883">{{cite journal |vauthors=Alkhawajah NM, Oger J |title=Late-onset myasthenia gravis: a review when incidence in older adults keeps increasing |journal=Muscle Nerve |volume=48 |issue=5 |pages=705–10 |date=November 2013 |pmid=23893883 |doi=10.1002/mus.23964 |url=}}</ref> The hallmark of myasthenia gravis is Fluctuating [[weakness]] of specific [[Muscle|muscles]] in [[limbs]], [[bulbar]], [[ocular]] and [[respiratory system]] which get worse with activity or using the muscle.<ref name="pmid23117946">{{cite journal |vauthors=Silvestri NJ, Wolfe GI |title=Myasthenia gravis |journal=Semin Neurol |volume=32 |issue=3 |pages=215–26 |date=July 2012 |pmid=23117946 |doi=10.1055/s-0032-1329200 |url=}}</ref><ref name="pmid15052614">{{cite journal |vauthors=Keesey JC |title=Clinical evaluation and management of myasthenia gravis |journal=Muscle Nerve |volume=29 |issue=4 |pages=484–505 |date=April 2004 |pmid=15052614 |doi=10.1002/mus.20030 |url=}}</ref><ref name="pmid6951497">{{cite journal |vauthors=Keesey J, Buffkin D, Kebo D, Ho W, Herrmann C |title=Plasma exchange alone as therapy for myasthenia gravis |journal=Ann. N. Y. Acad. Sci. |volume=377 |issue= |pages=729–43 |date=1981 |pmid=6951497 | The [[age of onset]] in Myasthenia gravis follows a bimodal distribution. The early type (before age of 50) is [[female]] predominant and the late type (after age of 60) is [[male]] predominant. Between the age of 50-60 there is no significant different between [[male]] and [[female]].<ref name="pmid23893883">{{cite journal |vauthors=Alkhawajah NM, Oger J |title=Late-onset myasthenia gravis: a review when incidence in older adults keeps increasing |journal=Muscle Nerve |volume=48 |issue=5 |pages=705–10 |date=November 2013 |pmid=23893883 |doi=10.1002/mus.23964 |url=}}</ref>About 50 percent of patiens have [[ptosis]] and [[diplopia]] as their presenting sign. [[Ptosis]] is usually asymmetrical. The direction and degree of [[diplopia]] may change in a [[Myasthenia gravis|MG]] patients because of [[Fatigue|fatigable]] [[ocular]] motor [[paresis]].<ref name="pmid7369304">{{cite journal |vauthors=Osher RH, Glaser JS |title=Myasthenic sustained gaze fatigue |journal=Am. J. Ophthalmol. |volume=89 |issue=3 |pages=443–5 |date=March 1980 |pmid=7369304 |doi= |url=}}</ref> | ||
The hallmark of myasthenia gravis is Fluctuating [[weakness]] of specific [[Muscle|muscles]] in [[limbs]], [[bulbar]], [[ocular]] and [[respiratory system]] which get worse with activity or using the muscle.<ref name="pmid23117946">{{cite journal |vauthors=Silvestri NJ, Wolfe GI |title=Myasthenia gravis |journal=Semin Neurol |volume=32 |issue=3 |pages=215–26 |date=July 2012 |pmid=23117946 |doi=10.1055/s-0032-1329200 |url=}}</ref><ref name="pmid15052614">{{cite journal |vauthors=Keesey JC |title=Clinical evaluation and management of myasthenia gravis |journal=Muscle Nerve |volume=29 |issue=4 |pages=484–505 |date=April 2004 |pmid=15052614 |doi=10.1002/mus.20030 |url=}}</ref><ref name="pmid6951497">{{cite journal |vauthors=Keesey J, Buffkin D, Kebo D, Ho W, Herrmann C |title=Plasma exchange alone as therapy for myasthenia gravis |journal=Ann. N. Y. Acad. Sci. |volume=377 |issue= |pages=729–43 |date=1981 |pmid=6951497 |doi= |url=}}</ref> | |||
==Complications== | ==Complications== | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Natural History
The age of onset in Myasthenia gravis follows a bimodal distribution. The early type (before age of 50) is female predominant and the late type (after age of 60) is male predominant. Between the age of 50-60 there is no significant different between male and female.[1]About 50 percent of patiens have ptosis and diplopia as their presenting sign. Ptosis is usually asymmetrical. The direction and degree of diplopia may change in a MG patients because of fatigable ocular motor paresis.[2]
The hallmark of myasthenia gravis is Fluctuating weakness of specific muscles in limbs, bulbar, ocular and respiratory system which get worse with activity or using the muscle.[3][4][5]
Complications
Prognosis
The prognosis of myasthenia gravis depends on:
- Disease duration at diagnosis: If the symptoms last less than 1 year, the patient has a 25 percent chance of going into remission by 10 years.[6]
- Disease severity[6]
- The age of onset: Younger patients seems to have better chance for remission than older ones.[6] Patients more than 50 years old are more prone to myasthenia crises like respiratory failure.[7]
References
- ↑ Alkhawajah NM, Oger J (November 2013). "Late-onset myasthenia gravis: a review when incidence in older adults keeps increasing". Muscle Nerve. 48 (5): 705–10. doi:10.1002/mus.23964. PMID 23893883.
- ↑ Osher RH, Glaser JS (March 1980). "Myasthenic sustained gaze fatigue". Am. J. Ophthalmol. 89 (3): 443–5. PMID 7369304.
- ↑ Silvestri NJ, Wolfe GI (July 2012). "Myasthenia gravis". Semin Neurol. 32 (3): 215–26. doi:10.1055/s-0032-1329200. PMID 23117946.
- ↑ Keesey JC (April 2004). "Clinical evaluation and management of myasthenia gravis". Muscle Nerve. 29 (4): 484–505. doi:10.1002/mus.20030. PMID 15052614.
- ↑ Keesey J, Buffkin D, Kebo D, Ho W, Herrmann C (1981). "Plasma exchange alone as therapy for myasthenia gravis". Ann. N. Y. Acad. Sci. 377: 729–43. PMID 6951497.
- ↑ 6.0 6.1 6.2 Beghi E, Antozzi C, Batocchi AP, Cornelio F, Cosi V, Evoli A, Lombardi M, Mantegazza R, Monticelli ML, Piccolo G (December 1991). "Prognosis of myasthenia gravis: a multicenter follow-up study of 844 patients". J. Neurol. Sci. 106 (2): 213–20. PMID 1802969.
- ↑ Bever CT, Aquino AV, Penn AS, Lovelace RE, Rowland LP (November 1983). "Prognosis of ocular myasthenia". Ann. Neurol. 14 (5): 516–9. doi:10.1002/ana.410140504. PMID 6651238.