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Journal of Neurology and Neurorehabilitation Research | Volume 4
November 04-05, 2019 | Melbourne, Australia
Neurology and Neurological Disorders
19
th
International Conference on
J Neurol Neurorehabil Res, Volume 4
A case report of Myasthenia Gravis treated with Plasmapharesis
Theresia Christin
Sriwijaya University, Indonesia
Background:
Myasthenia gravis is a neuromuscular
autoimmune disorder. The most common form is muscle
weakness that is not accompanied by pain, weakness
is exacerbated by activity and improves when resting.
Exacerbations and remissions can occur, especially in the
first years of the disease. Remission rarely occurs complete
or permanent.
Case Report:
A 35-year-old woman was treated in the
Neurology Department of RSMH due to being unable to
eat and drink due to not being able to swallow slowly.
The diagnosis of myasthenia is made primarily from
clinical presentation, which is based on history taking and
neurological physical examination and continued with
additional work up. In electrophysiological examination,
characteristic of myasthenia which is the rapid reduction
of amplitude in CMAP during serial repetitive stimulation
on peripheral nerve at frequency of 3/ second was found.
Previous diagnosis have been made through ENMG with
Harvey Masland positive without thymoma (normal chest
CT scan). Although a definitive diagnosis is obtained by
examination of antiacetylcholine receptor antibodies, using
repetitive nerve stimulation is quite specific and indicates a
high likelihood that this patient is diagnosed with myasthenia
gravis. Clinically, patients are categorized through the clinical
classification of MGFA as Class IIIb, where the patient mainly
affectstheoropharyngealmuscleswithamoderateweakness.
During treatment the patient was given corticosteroids
and antiacetylcholinesterase. The choice of corticosteroids
and antiacetylcholinesterase as therapy clinically provides
improvement in patients.
Conclusion:
Myasthenia gravis is a fluctuating disease. Clinical
repair and worsening can occur. Exacerbation of myasthenia
is a general term that can be defined as an increase in the
degree of weakness in the bulbar muscles, breathing, or
muscles of the arms and legs. Both conditions of this crisis
show almost the same clinical appearance. The choice of
therapy and dosage must be adjusted to each individual's
condition.
e
:
dr.theresiachristinsp.s@gmail.com