MYASTHENIA GRAVIS: MEDICAL ASPECTS.
The diagnosis of myasthenia gravis is often difficult and calls for a broader use of pharmacological and electrodiagnostic tests. The decamethonium-edrophonium test, which has proved superior to other procedures for this purpose, is based on neurophysiological principles and depicts the behaviour of the neuromuscular junction. A state of resistance to depolarizing agents in the limited form of myasthenia and a state of a non-depolarizing (competitive) block in advanced cases has been shown. This test has demonstrated that the neuromuscular defect exists throughout the skeletal musculature, including muscles clinically unaffected. It produced no false-positive results either in normal or neurasthenic persons or in patients with neurological diseases with myasthenic symptoms. In a patient with botulism and in a patient with ocular palsies from brain-stem encephalitis the edrophonium test gave a false-positive result, while the decamethonium-edrophonium test was negative.Diagnosis, treatment and management of myasthenic emergencies are described.
D000109:Acetylcholine; D001906:Botulism; D001965:Bromides; D002800:Cholinesterase Inhibitors; D003650:Decamethonium Compounds; D003933:Diagnosis; D003937:Diagnosis, Differential; D004358:Drug Therapy; D004491:Edrophonium; D004568:Electrodiagnosis; D004660:Encephalitis; D005260:Female; D006801:Humans; D009470:Muscle Spindles; D009132:Muscles; D009157:Myasthenia Gravis; D009469:Neuromuscular Junction; D003473:Neuromuscular Nondepolarizing Agents / Q000037:antagonists & inhibitors*; D009497:Neurotic Disorders; D010600:Pharmacology; D011189:Potassium Chloride; D011247:Pregnancy; D011248:Pregnancy Complications; D013148:Spironolactone; D013934:Thymectomy
D001965:Bromides; D002800:Cholinesterase Inhibitors; D003650:Decamethonium Compounds; D003473:Neuromuscular Nondepolarizing Agents; D013148:Spironolactone; D011189:Potassium Chloride; D004491:Edrophonium; C033019:decamethonium; D000109:Acetylcholine
ACETYLCHOLINE; BOTULISM; BROMIDES; CHOLINESTERASE INHIBITORS; CURARIFORM ANTAGONISTS; DECAMETHONIUM COMPOUNDS; DIAGNOSIS; DIAGNOSIS, DIFFERENTIAL; DRUG THERAPY; EDROPHONIUM CHLORIDE; ELECTRODIAGNOSIS; ENCEPHALITIS; MYASTHENIA GRAVIS; NEUROMUSCULAR SPINDLES; NEUROSES; PHARMACOLOGY; POTASSIUM CHLORIDE; PREGNANCY; PREGNANCY COMPLICATIONS; SPIRONOLACTONE; THYMECTOMY