What Are the Different Types of Myasthenia Gravis?

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 depolarized and this depolarization travels to the axon terminal. Voltage-gated calcium channels open, leading to acetylcholine containing vesicles to fuse to the cell membrane. Acetylcholine is then released from synaptic vesicles into the synaptic cleft from the axon terminal. The acetylcholine travels across the synaptic cleft to the AChR [acetylcholine receptor] sites where binding causes sodium channels to open, depolarizing the motor end plate of the muscle fiber. Acetylcholinesterase degrades the acetylcholine, and the sodium channels close, allowing repolarization of the muscle fiber.” The diagnosis of MG is made by history of fatiguable weakness, clinical examination trying to fatigue muscles such as continuous upward gaze (patients worsen with this activity), physiological testing such as the Tensilon test (which has improved symptoms when the drug is...
Source: PediatricEducation.org - Category: Pediatrics Authors: Tags: Uncategorized Source Type: news

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Source: Medscape Pathology Headlines - Category: Pathology Tags: Cardiology News Source Type: news
Conclusion. Over the 2-year follow-up period, PTED did not show superior clinical outcomes and did not appear to be safer procedure for patients with LDH compared with MED. PTED had inferior results for median disc herniation, whereas MED did not appear to be the best option for far-lateral disc herniation. Level of Evidence: 2
Source: Spine - Category: Orthopaedics Tags: RANDOMIZED TRIAL Source Type: research
Study Design. Cross-sectional. Objective. The aim of this study was to describe the self-experienced trunk appearance in individuals with and without idiopathic scoliosis. Summary of Background Data. Idiopathic scoliosis is the most common spinal deformity. A large scoliotic deformity increases the risk of back pain and pulmonary dysfunction. The deformity has also a psychological impact. Methods. The pictorial part of the spinal appearance questionnaire (pSAQ) was administered to 1416 individuals with idiopathic scoliosis (386 untreated, 529 brace treated, 501 surgically treated) and 272 individuals without sco...
Source: Spine - Category: Orthopaedics Tags: DEFORMITY Source Type: research
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Source: Spine - Category: Orthopaedics Tags: EPIDEMIOLOGY Source Type: research
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Source: Spine - Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
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Source: Spine - Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
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Source: Spine - Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
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Source: Spine - Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research
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Source: Spine - Category: Orthopaedics Tags: LITERATURE REVIEW Source Type: research
Study Design. Retrospective study. Objective. The purpose of the present study is to determine how body mass index (BMI) affects patient-reported outcome measurements (PROMs) after lumbar fusions. Summary of Background Data. Although greater preoperative BMI is known to increase the rates of adverse events after surgery, there is a paucity of literature assessing the influence of BMI on PROMs after lumbar fusion. Methods. Patients undergoing lumbar fusion surgery between 1 and 3 levels were retrospectively identified. PROMs analyzed were the Short Form-12 Physical Component Score, Mental Component Score, Oswestr...
Source: Spine - Category: Orthopaedics Tags: SURGERY Source Type: research
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