Acute Myasthenia Crisis: A Critical Emergency Department Differential

Hogan, Christopher D; Lee, Jenny; Sleigh, Bryan C; Banerjee, Paul; Ganti, Latha

doi:10.7759/cureus.9760

Cited by 4 publications

(3 citation statements)

References 7 publications

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“…Although some patients (15%) experience ocular symptoms only, the majority (85%) have more generalised symptoms [ 4 ]. Indeed, an exacerbation of generalised muscle weakness can result in a life-threatening myasthenic crisis, requiring respiratory support [ 6 ]. Beyond muscle weakness and muscle fatiguability, many patients also report central fatigue, experienced as a lack of physical and/or mental energy, which is associated with reduced quality of life [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…Systemic biologics such as rituximab and eculizumab can be used to treat refractory disease. Plasma exchange and intravenous immunoglobulin are fast-acting treatments typically used in conjunction with intensive care to manage myasthenic crisis [ 4 , 6 ]. Ongoing clinical trials provide hope for additional treatment options in the near future [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

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The Lived Experience of Myasthenia Gravis: A Patient-Led Analysis

et al. 2021

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Introduction A greater understanding of the reality of living with myasthenia gravis (MG) may improve management and outcomes for patients. However, there is little published data on the patient perspective of how MG impacts life. Our objective was to reveal the lived experience of MG from the patient perspective. Methods This analysis was led by an international Patient Council comprising nine individuals living with MG who serve as local/national patient advocates in seven countries (Europe and the United States). Insights into the lived experience of MG were consolidated from three sources (a qualitative research study of 54 people with MG or their carers from seven countries; a previous Patient Council meeting [September 2019]; and a literature review). Insights were prioritised by the Patient Council, discussed during a virtual workshop (August 2020) and articulated in a series of statements organised into domains. Overarching themes that describe the lived experience of MG were identified by the patient authors. Results From 114 patient insights and supporting quotes, the Patient Council defined 44 summary statements organised into nine domains. Five overarching themes were identified that describe the lived experience of MG. These themes include living with fluctuating and unpredictable symptoms; a constant state of adaptation, continual assessment and trade-offs in all aspects of life; treatment inertia, often resulting in under-treatment; a sense of disconnect with healthcare professionals; and feelings of anxiety, frustration, guilt, anger, loneliness and depression. Conclusion This patient-driven analysis enriches our understanding of the reality of living with MG from the patient perspective. Supplementary Information The online version contains supplementary material available at 10.1007/s40120-021-00285-w.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Lived Experience of Myasthenia Gravis: A Patient-Led Analysis

et al. 2021

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“…Os distúrbios decorrentes da MGJ podem evoluir de forma crítica, necessitando de cuidados intensivos 11 , principalmente quando há necessidade de suporte ventilatório mecânico 12,13 . Neste contexto, falhas sucessivas de extubação podem indicar a realização da traqueostomia, uma vez que esse dispositivo pode facilitar a transição para a ventilação espontânea, como se deu com a criança do presente relato de caso.…”

Section: Discussionunclassified

Miastenia Gravis Juvenil, atuação fisioterapêutica e desospitalização: relato de caso

et al. 2021

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Objetivo. Descrever a atuação fisioterapêutica e a evolução funcional de uma criança com Miastenia Gravis Juvenil (MGJ). Método. Estudo observacional, descritivo, longitudinal, retrospectivo, de caso único: relato de caso; desenvolvido em hospital pediátrico de referência, em Salvador, Bahia, Brasil, através de dados de prontuário, registrados pela equipe multiprofissional de saúde, sobre a evolução clínica e funcional da criança. Resultados. Paciente MRS deu entrada em Unidade de Pronto Atendimento, com descompensação clínica, evoluiu para quadro de choque séptico e insuficiência respiratória aguda, levando à intubação orotraqueal. Foi transferida para Unidade de Terapia Intensiva, onde foi diagnosticada com pneumonia comunitária e após falhas na extubação, submetida à traqueostomia. Foi transferida para Unidade de Treinamento em Desospitalização (UTD), onde a fraqueza muscular persistente levou a investigação e diagnóstico de MGJ. Nesta unidade recebeu intervenções fisioterapêuticas com foco na atividade e participação, apresentou progressos no quadro motor, realizando ortostatismo independente, deambulação e subida/descida de escadas com suporte unilateral. Entretanto, permaneceu em ventilação mecânica invasiva. Conclusão. A atuação fisioterapêutica foi pautada na funcionalidade, visando capacidade e desempenho, utilizando-se da ludicidade como ferramenta para estimular a adesão ao tratamento. Como desfecho funcional, houve redução do grau de deficiências e limitações.

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