Cc: fatigue or difficulty swallowing, or ptosis
Diagnosis:
Myasthenia graves
Differential diagnosis :
Stroke
Multiple sclerosis
Guillain barré syndrome
Lamber-eaton myasthenia syndrome
Tests , for Myasthenia graves :
Anti-AChR antibodies
Anti-MuSK antibodies
EMG
Edrophonium ( tension ) test
CT or MRI chest to look for thymoma
TFT to look for grave’s disease
FVC, to assess respiratory muscle function
Ice test
Management of Myasthenia Graves :
Acute:
IVIG or plasmapheresis
Chronic:
Acetylcholine esterase inhibitor like pyridostigmine
Immunesupression like Steroids & azathioprine
Thymectomy
Remember :
• Worsening may occur with medication such as fluoroquinolones, aminoglycosides, and
magnesium
• Immunosuppressive therapy should be maintained throughout pregnancy, as this reduces
the chance of neonatal muscle weakness, and controls the mother’s myasthenia
