Myasthenia Gravis
Myasthenia Gravis (重肌無力症) - Generalised muscle fatigue symptom
Causes
- Self Auto-immune over activity against own body components
- Antibodies against Acetycholine muscle end plate receptors, blocking normal neuromuscular transmission.
- Usually become symptomatic from young adulthood (triggering factor unknown)
Related body changes and diseases
- Thymic disease
Thymic carcinoma
Thymic tumour (benign)
Thymic hyperplasia, enlarged thymus - Thyotoxicosis thyroid disorder
Autoimmune thyroid diesase, may affect eyes
- Thyroid disorder
Thyoiditis or low thyroid hormone
- Non thymic carcinoma
Carcinoma of lung (Eaton Lambert syndrome)
Treatment of Myasthenia Gravis
- Chronic disease
- Medications
- Imnunosuppresant: Steroid & Non-sternoid
- Operation: Total thymectomy - Acute disease or excerbation
- Medication
- Respiratory support- ventilation, oxygen
- Plasmapharesis
- Intravenous immunoglobulin - Prognosis (outlook)
- Over 70% show response to surgery after 6 month
- Final outcome depend on stage, extent of involement (Osler staging)
- Surgical outcome related to timing of surgery after symptom onset, completeness of surgery, ocular Myasthenia traditionally not good response but up to challange nowadays - Surgical advance in Myasthenia Gravis thymectomy
- Single port endoscopic total thymectomy
- Subpxiphoid endoscopic thymectomy
- Robotic assisted thoracopic thymectomy