Myasthenia gravis

Neuropsychiatry Department Prof Aymen Youssef Ezz El Din ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],Dr Amr Al Fatatry Dr Jaeda Mekky Dr Heba Essam Dr Hisham Sheshtawy Dr Hisham Abud 2008-09

http://groups.google.com/group/alexneuropsych E-mail: [email_address] [email_address]

Myasthenia Gravis: Update Dr Ashraf Abdou Professor Neuropsychiatry dept

Clinical ,[object Object],[object Object],[object Object],[Orphan disease]

Incidence ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Myasthenia Gravis is an autoimmune Disease that is characterized by a decrease in number of AChR Because there are fewer AChR to bind to the end plate potentials (EPPs) are smaller. With smaller EPPs the “ safety factor” is reduced there is less chance that the post-synaptic muscle fibres will be activated

Note: The amplitude of the end plate-potential is directly related to the amount of ACh that binds to the post-synaptic AChRs.

Pathophysiology ,[object Object],[object Object],[object Object],[object Object]

Etiology ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical features ,[object Object],[object Object],[object Object],[object Object],[object Object]

Clinical [cont.] ,[object Object],[object Object],[object Object]

Diagnosis and Ix ,[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnosis ,[object Object],[object Object]

[object Object],[object Object],[object Object],[object Object],[object Object]

Cholinesterase Inhibitors ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Evidence based long-term management of MG ,[object Object],[object Object]

Immunomodulatory therapy ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Immunomodulatory therapy [Short-term] ,[object Object],[object Object],When acute temporary improvement is needed.

IVIG ,[object Object],[object Object]

Plasmapheresis ,[object Object],[object Object],[object Object]

Immunomodulatory therapy [long-term] ,[object Object],[object Object],To induce remission

Thymectomy ,[object Object],[object Object],[object Object],[object Object]

Thymectomy [cont.] ,[object Object],[object Object],[object Object],[object Object]

Immunomodulatory Drugs [Long-term] ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

We should WAIT 1-2 months Cellcept 1-3 months Methotraxate 6-8 months Azathioprine 1-3 months Corticosteroids One year Thymectomy

Myasthenia gravis

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Myasthenia gravis