Myasthenia gravis

W. K. Engel, B. W. Festoff, B. M. Patten, Michael L. Swerdlow, H. H. Newball, M. D. Thompson

Research output: Contribution to journalArticle

56 Citations (Scopus)

Abstract

In myasthenia gravis, fatigability and persistent, often fatal weakness of voluntary muscles are attributable to dysfunction at the neuromuscular junction. The overall dysimmune state of the patient probably causes the junctional defect. 70% of patients have thymic hyperplasia and 10%, thymoma. The atrophy of muscle fibers usually looks like denervation atrophy, and there are morphologic abnormalities of motor axon endings and the postsynaptic region of the muscle fiber. Electromyographic studies detect the neuromuscular junction defects: fatigue on repetitive stimulation and post tetanic exhaustion. 'Open biopsy EMG' confirms that the commonly found electromyographic pattern comes from regions showing only denervation like atrophy of muscle fibers. Other diagnostic tests include benefit from anticholinesterases and worsening by d tubocurarine; the worsening of weakness by lactate infusion might serve as a diagnostic test. Treatment includes anticholinesterases, thymectomy, and the recently introduced long term, high single dose, alternate day prednisone program. Experienced 24 hr nursing surveillance is essential to treatment of the severely myasthenic patient.

Original languageEnglish (US)
Pages (from-to)225-246
Number of pages22
JournalAnnals of Internal Medicine
Volume81
Issue number2
StatePublished - 1974
Externally publishedYes

Fingerprint

Myasthenia Gravis
Muscular Atrophy
Neuromuscular Junction
Cholinesterase Inhibitors
Denervation
Routine Diagnostic Tests
Thymus Hyperplasia
Tubocurarine
Thymectomy
Thymoma
Muscle Weakness
Prednisone
Atrophy
Fatigue
Axons
Lactic Acid
Skeletal Muscle
Nursing
Biopsy
Muscles

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Engel, W. K., Festoff, B. W., Patten, B. M., Swerdlow, M. L., Newball, H. H., & Thompson, M. D. (1974). Myasthenia gravis. Annals of Internal Medicine, 81(2), 225-246.

Myasthenia gravis. / Engel, W. K.; Festoff, B. W.; Patten, B. M.; Swerdlow, Michael L.; Newball, H. H.; Thompson, M. D.

In: Annals of Internal Medicine, Vol. 81, No. 2, 1974, p. 225-246.

Research output: Contribution to journalArticle

Engel, WK, Festoff, BW, Patten, BM, Swerdlow, ML, Newball, HH & Thompson, MD 1974, 'Myasthenia gravis', Annals of Internal Medicine, vol. 81, no. 2, pp. 225-246.
Engel WK, Festoff BW, Patten BM, Swerdlow ML, Newball HH, Thompson MD. Myasthenia gravis. Annals of Internal Medicine. 1974;81(2):225-246.
Engel, W. K. ; Festoff, B. W. ; Patten, B. M. ; Swerdlow, Michael L. ; Newball, H. H. ; Thompson, M. D. / Myasthenia gravis. In: Annals of Internal Medicine. 1974 ; Vol. 81, No. 2. pp. 225-246.
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