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Myasthenia Gravis Introduction Definition: -chronic, immune neurological disease -defect in transmission of nerve impulses at the neuromuscular junction -antibodies attack acetylcholine receptors Peak onset: 20 – 30 yrs. Old Females are 3X > Males About 20 per 100,000 affected* Not hereditary ( small familial incidence) Thymus gland often abnormal (hyperplasia) Strong association between MG and hyperthyroidism *http://www.myasthenia.org/amg_whatismg.cfm Muscle weakness within voluntary muscles -ptosis -abnormal vision -difficulty chewing/swallowing -weakness of arms and legs -chronic muscle fatigue -possibly difficulty breathing Tensilon test (anticholinesterase) edrophonium chloride:med will enhance neurotransmission shows marked muscle tone improvement for about 4-5 mins. ANTIDOTE for Tensilon: Atropine Sulfate EMG (electromyography): muscle response decreased with repeated stimulation Thyroid function tests: some MG patients have increase Serum protein electrophoresis: evaluate for immunologic disorders Acetylcholine receptor antibodies testelevated