title: Myasthenia gravis: pathophysiology, diagnosis and collaborative care.
abstract: Myasthenia Gravis (MG) is an autoimmune disorder which compromises neuromuscular transmission. The hallmark of the disorder is fatigue with repetitive activity. Patients may experience symptoms ranging from double vision, ptosis and weak voice to choking, shortness of breath, generalized weakness and respiratory failure. The clinical diagnosis is confirmed by identification of a decremental response to repetitive nerve stimulation by electromyography (EMG), the presence of serum antibodies to the muscle acetylcholine receptor (AChR), or an improvement in strength with administration of intravenous edrophonium. With improvements in critical care and immunosuppressive treatments, MG is rarely the grave disease it once was, but because of the odd fatiguing symptoms and relative rarity of the disorder, patients are frequently misdiagnosed and their special needs overlooked. The nature of MG, with its acute and chronic components, creates complex needs for affected individuals and their families. The advanced practice nurse in collaboration with a neurologist in the outpatient setting is positioned to address these needs in an ongoing case management role.
mesh_terms: D001323:Autoantibodies / Q000097:blood; D003131:Combined Modality Therapy; D004491:Edrophonium; D004576:Electromyography; D006801:Humans; D018482:Muscle, Skeletal / Q000294:innervation; D009157:Myasthenia Gravis / Q000175:diagnosis / Q000451:nursing* / Q000503:physiopathology; D009730:Nursing Assessment; D009733:Nursing Diagnosis; D010348:Patient Care Team; D010353:Patient Education as Topic; D011950:Receptors, Cholinergic / Q000276:immunology; D009435:Synaptic Transmission / Q000502:physiology
chemical_list: D001323:Autoantibodies; D011950:Receptors, Cholinergic; D004491:Edrophonium