Podcast # 437 : Myasthenia Gravis

Myasthenia gravis (MG) is an antibody mediated autoimmune disorder against the acetylcholine receptors at the neuromuscular junctions.

Bimodal age distribution (20's-30's: women; 60's-70's: men)

Presents with fluctuating muscle weakness typically worse at the end of the day with upper extremities affected more than lower and typically involving facial muscles.

Myasthenia crisis occurs when muscle fatigue begins to cause respiratory depression

MG was historically diagnosed with the Tensilon test but now often by EMG

Treatment of MG crisis involves plasma exchange and IVIG. Those in crisis often require intubation and ICU admission