A case report of Myasthenia Gravis treated with Plasmapharesis
19th International Conference on Neurology and Neurological Disorders
November 04-05, 2019 | Melbourne, Australia
Sriwijaya University, Indonesia
Posters & Accepted Abstracts : J Neurol Neurorehabil Res
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
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 affects the oropharyngeal muscles with a moderate weakness. 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.