Use of Noninvasive Ventilation with Volume-assured Pressure Support for Treatment-refractory Myasthenia Gravis

by MONTSERRAT DIAZ-ABAD, MD; NEVINS TODD, MD; LINDSAY ZILLIOX, MD; ANA SANCHEZ, MD; and CHARLENE HAFER-MACHO, MD Dr. Diaz-Abad and Dr. Todd are with the Department of Medicine, University of Maryland School of Medicine in Baltimore, Maryland. Drs. Zilliox, Sanchez, and Hafer-Macko are with the Department of Neurology, University of Maryland School of Medicine in […] The post Use of Noninvasive Ventilation with Volume-assured Pressure Support for Treatment-refractory Myasthenia Gravis appeared first on Innovations in Clinical Neuroscience.
Source: Innovations in Clinical Neuroscience - Category: Neuroscience Authors: Tags: Case Report Current Issue Sleep Disorders Myasthenia gravis noninvasive ventilation respiratory failure sleep hypoventilation treatment-refractory volume-assured pressure support Source Type: research

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It’s not often that a person growing up among the cotton fields of southwest Oklahoma goes on to become a successful manager of global technology companies, but Leland White is not your average person. During his career, he built and managed semiconductor manufacturing plants around the world and provided management consulting services to large corporations and federal agencies. After a successful business career, he retired in Colorado to pursue two passions: downhill skiing and high-performance driving. Referred to by family and friends as “Lee,” he turned 78 last spring. I talked to Lee about the chall...
Source: American Speech-Language-Hearing Association (ASHA) Press Releases - Category: Speech-Language Pathology Authors: Tags: Health Care Slider Speech-Language Pathology Dysphagia Swallowing Disorders Source Type: blogs
We describe a case of a 43-year-old African American female with MG who was brought in for shortness of breath. History included MG diagnosed twelve years prior to the current presentation and a history of seven intubations. The patient was admitted to the ICU and intubated. She endorsed poor sleep, easy fatigability, and feeling hopeless in the context of psychosocial stressors-being single, homeless, and unemployed. The patient was started on Zoloft 50 mg per oral daily for depression and Atarax 50 mg per oral three times a day for anxiety. The patient responded well to the treatment and was discharged on d...
Source: Case Reports in Psychiatry - Category: Psychiatry Tags: Case Rep Psychiatry Source Type: research
Discussion Myasthenia gravis (MG) is a problem of the neuromuscular junction which causes muscle weakness. It can occur in all ages and have a range of symptoms from mild localized disease to mortality-threatening respiratory failure. MG occurs in 1.7-30 cases/million, with a prevalence of 77.7 cases/million. Pediatric patients comprise 10-15% of all patients with MG. In various Asian populations, the juvenile MG can be up to 50% of all of the MG cases. Fluctuations in muscle weakness is a hallmark of the disease. As a reminder, “[i]n normal synaptic transmission in the neuromuscular junction, the axon is depolarize...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news
ConclusionsThis study showed that the occurrence of OSA in patients with MG is associated with male sex and obesity, which is in accordance with the normal population. Moreover, PSG data showed a high prevalence of supine dominant OSA in MG patients with OSA.
Source: Neurological Sciences - Category: Neurology Source Type: research
Myasthenia gravis (MG) is an autoimmune disorder with antibodies targeted to acetylcholine receptors (AChRs) in the postsynaptic membrane [1]. Impaired neuromuscular junction transmission results in weakness of skeletal muscles [1]. Diagnostic tests for MG include single fiber electromyography [2], repetitive nerve stimulation test [3], acetylcholine receptor antibody (AChR-Ab) assay [4], rest test [5], ice-pack test [6], sleep test [7], and Tensilon ® or neostigmine test [8]. In patients with negative AChR-Ab, antibodies against muscle-specific kinase (MuSK), low-density lipoprotein receptor–related protein 4 (L...
Source: Neuromuscular Disorders - Category: Neurology Authors: Source Type: research
ConclusionFatigue in MG is highly prevalent, mainly physical, and influenced by depressive symptoms, disease severity, female sex and sleep debt. Cognitive fatigue in MG may not be a direct disease manifestation, but secondary to depression. The FSS and FIS represent reliable and validated tools, appropriate to discern meaningful clinical aspects of fatigue in MG. Clinical recognition of the complexity of fatigue may foster individualized treatment approaches for affected MG patients.
Source: Journal of Neurology - Category: Neurology Source Type: research
AbstractPurpose of ReviewMyasthenia gravis (MG) is traditionally conceptualized as a disease with purely motor manifestations. This paper reviews the supporting evidence and pathophysiology of non-motor symptoms in MG, including pain, headache, special sense and autonomic dysfunction, sleep disturbance, and cognitive and psychosocial issues.Recent FindingsWork in this area has been limited. Recent studies have identified bodily pain and headache as common complaints in patients with MG. A growing literature also suggests that there may be an association of MG and sleep disturbance (both obstructive sleep apnea and sleep cy...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
I read with interest the article by Oliveira et  al, who investigated sleep, lung function, and quality of life in 25 patients with myasthenia gravis (MG) [1]. Patients exhibited a high prevalence of sleep-disordered breathing, significant reductions in maximum inspiratory and expiratory pressures, and impairment of health-related quality of lif e. I have some concerns about their study with special reference to sleep-disordered breathing including obstructive sleep apnoea (OSA).
Source: Neuromuscular Disorders - Category: Neurology Authors: Tags: Letter to the Editor Source Type: research
Conclusion: Incidence of diaphragm dysfunction is higher in patients presenting with myasthenic crisis. This study also demonstrated a high incidence of diaphragm dysfunction in patients with stable MG. It is important to evaluate diaphragm functions in patients with stable MG.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Clinical Problems Others Source Type: research
Conclusion: Our study showed a considerable increase in EDS and The BQ proved good sensitivity to identify patients at risk for OSA in a population of patients with MG.
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Sleep and Control of Breathing Source Type: research
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