How is myasthenic crisis diagnosed?

Some nervous diseases are difficult to diagnose by doctors during the initial treatment of patients. These diseases include myasthenia gravis. The initial complaints, voiced by the patient, are of rapid fatigue. But after rest, muscle fatigue recedes for a short time, and the patient again feels quite normal.

Meanwhile, myasthenia gravis is a violation of the neuromuscular transmission of signals from the central nervous system to striated muscles, from - why abnormal cyclic fatigue appears after a slight load.

Article content
  • Types of myasthenic syndrome
  • Myasthenic crisis
  • Crisis Treatment
  • Disease Details

    How is myasthenic crisis diagnosed?

    Distinguish between immune-dependent myasthenia gravis and myasthenic syndromes.

    The reason for the first is autoimmune diseases, the development of syndromes is due to a set of developmental defects: postsynaptic and presynaptic.

    These defects are nothing more than a violation of the synthesis of substances necessary for the normal functioning of the body and a defect in the organs of perception. Due to pathologies of organic processes, the function of the thymus gland is disrupted.

    The impetus for the launch of autoimmune diseases or disorders of biochemical processes in the body can be all factors that weaken the immune status, namely, infectious diseases, stress or trauma.

    < p> The following forms of myasthenia gravis can be distinguished:
    • ocular;
    • bulbar;
    • generalized.
    How is myasthenic crisis diagnosed?

    Some doctors believe that myasthenia gravis is associated with myasthenia gravis, and is not classified as a separate condition.

    The first symptoms of myasthenia gravis of the ocular form are damage to the muscles of the eyelids. Patients complain of drooping of the eyelids, rapid eye fatigue, duplication of the image.

    Then signs of bulbar myasthenia gravis join - the pharyngeal muscles, also innervated by the cranial nerves, atrophy.

    Chewing and swallowing functions are impaired, in the future, the timbre of the voice will change, the ability to articulate speech will disappear.

    With generalized myasthenia gravis, all muscles are gradually blocked - from top to bottom - from the cervical and scapular to the dorsal, then the muscles of the limbs are affected. Drooling appears, the patient becomes difficult to maintain himself, to perform the simplest actions, there is a feeling of weakness in the limbs.

    How is myasthenic crisis diagnosed?

    The increase in symptoms can stop at any stage.

    In children, the disease does not appear earlier than six months of age, in mostIn most cases, it is diagnosed in boys over 10 years of age. From the first symptoms - weakness of the eyelid muscles - up to 2 years pass until the next.

    In adulthood, in the period from 20 to 40, women are more likely to get sick, and at the age of over 65, the manifestation of the disease does not depend on gender. .

    Types of myasthenic syndrome

    There are several myasthenic syndromes caused by genetic defects.

    All they are inherited in an autosomal recessive manner, except for the autosomal dominant syndrome, which is caused by the slow closure of immune channels:

    How is myasthenic crisis diagnosed?
    1. Lambert-Eaton syndrome more often diagnosed in men over 40. Its main signs are the weakness of the proximal muscles of the extremities while maintaining the bulbar and extraocular muscles. Symptoms can be ahead of clinical manifestations, with physical exertion - playing sports, muscle weakness can be stopped;
    2. Congenital myasthenic syndrome. Signs - violation of symmetrical movement of the eyeballs and ptosis of the eyelids;
    3. Symptoms - weakness of the facial and skeletal muscles, the sucking function is impaired;
    4. Muscle hypotonia and underdevelopment of the synaptic apparatus causes a rare myasthenic syndrome, in which tendon reflexes are reduced. Typical signs of the condition are asymmetry of the face, mammary glands and trunk;
    5. Myasthenic syndromes can be caused by taking certain drugs: D-penicillamine and antibiotics: aminoglycosides and polypeptides. Improvement occurs within 6-8 months after discontinuation of the drug.

    The syndrome caused by the slow closure of ionic tubules has the following symptoms:

    • weakness of the oculomotor muscles;
    • muscle atrophy;
    • weakness in the limbs.

    Treatment of each case of myasthenia gravis is carried out according to a specific algorithm.

    May be used:

    • corticosteroids;
    • antibiotics;
    • < li> anticholinestasic drugs;
  • plasmapheresis and other types of specific therapy.
  • Drugs used for one form of the disease are ineffective for other forms.

    Myasthenic crisis

    How is myasthenic crisis diagnosed?

    The main symptoms of myasthenic crisis are extensive dysfunctions of the bulbar muscles, including the respiratory one, up to the onset of apnea .

    The intensity of symptoms grows at a critical rate - brain hypoxia mo may occur within half an hour.

    If emergency care is not provided for a sudden myasthenic crisis, the patient will suffocate.

    The following factors may be the reasons for the development of a crisis:

    • stressful conditions;
    • increased physical activity;
    • influenza;
    • acute respiratory diseases;
    • metabolic disorders;
    • hormonal imbalance ;
    • intoxication of various etiologies.

    These factors provoke a blockage of neuromuscular conduction, cause a loss of excitability in muscles and tendons .

    Patients with myasthenia gravis always have a note with them, which says that they suffer from such and such a form of the disease and what drugs are needed for first aid. In most cases, the patients carry drugs with them - proserin and kanevin .

    If there is at least 1 person among those around whose eyes a myasthenic crisis has developed who knows how to inject, a person's life will be saved. > it is still necessary.

    Crisis treatment

    How is myasthenic crisis diagnosed?

    The method of treating myasthenic crisis is completely determined by the patient's condition and by how quickly the emergency assistance was provided by the special team that arrived at the place of the call.

    As soon as possible, the victim needs to be placed in intensive care and connect to the ventilator - artificial respiration. Artificial ventilation of the lungs should be performed within 24 hours, at least.

    Effectively restores the state of plasmapheresis, but intravenous immunoglobulin may be required. Together with immunoglobulin, methylprednisolone and potassium chloride are used.

    Combined treatment with immunoglobulin, potassium chloride and methylprednisolone is used if there is a history of inflammatory processes.

    < p> Antioxidants are used - lipoic acid in particular. They reduce the amount of free radicals accumulated in the blood, reduce the severity of oxidative stress in the patient's body.

    The transition from the ventilator to spontaneous breathing is performed based on the clinical picture, the following factors are evaluated:

    How is myasthenic crisis diagnosed?
    • stabilization of heart rate and depth and respiratory rate;
    • absence of cyanosis and agitation;
    • absence of disturbance of consciousness;
    • respiratory muscles begin to participate in the process of breathing;
    • pupils' reactions to light stimuli.

    In addition , the blood test values ​​obtained by laboratory are taken into account.

    The patient can stay on the ventilator for up to 4 days. If during this time spontaneous breathing is not restored, surgical intervention is performed to impose a tracheostomy - this helps to stop tracheal pressure ulcers.

    Due to the level of development of modern medicine in general and equipment of intensive care units, in particular, the training of special medical teams, the mortality rate from myasthenic crisis has decreased in comparison with the situations in 1990 by 12 times.

    If you see a person on the street who begins to suffocate before our eyes, his skin begins to turn pale or turn blue, be sure you need to call an ambulance. The life of such people largely depends onthe pleasure of indifference of others.