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Myasthenia gravis is an autoimmune disease affecting the bony neuromuscular junction . The clinical presentation of myasthenia gravis is subsequent to release of autoantibody against postsynaptic nicotinic acetylcholine receptor in skeletal muscles or in some cases autoantibodies against muscleman specific receptor tyrosine kinase are released . This leads to brawn weakness with repetitive work . The symptom are fluctuant and presents with lapsing and remit . It is known to resolve ad lib in some patients , but in most of the patients it persist for life . The disease has dynamical form and can occur at any historic period , but usually female are affected at a younger age ( around 30 years ) ; whereas , males are affected at a ulterior part of life ( after 50 years of age ) .
What Psychiatric Disorder Is Most Commonly Associated With Myasthenia Gravis?
Apart from motor disabilities in myasthenia gravis , psychological disorders have also been entail in the disease . Since the disease is inveterate , debilitating and liveliness endanger if respiratory distress occur , psychological disorders are normally associated with it . There have been very few studies that have search the psychological symptom of the disease . Some studies have point increased relative incidence of epilepsy in these patients , some have shown increase prevalence of sleep disorders and cognitive stultification due to the persona of cholinergic system of rules in the disease . Most of the data on neurological facet of the disease is old with miserable methodology ; therefore there is no well-defined consensus regarding the psychiatrical pathology of the disease .
The most usually associated psychiatrical weather condition to myasthenia gravis are anxiousness disorder , such as generalised anxiety upset or panic disorderliness , in addition to depressive disorders . Bothanxietyanddepressionwere more prevalent in myasthenia gravis patients than normal universe . There is scarcity of data regarding the preponderance and the cause of these psychiatric disorders in myasthenia gravis . Researchers are slanted regarding the aetiology of the neurological symptom . Some consider it squeal to the chronicity and enfeeble nature of the disease progression ; while others hypothesize that there might be CNS involvement in the pathogenesis of psychiatrical participation .
There should be an understanding of both psychiatrical condition and myasthenia gravis , since overlapping symptoms may either retard diagnosis of either conditions or may run to unnecessary drug handling . The overlapping symptoms of both the diseases includefatigue , thin out zip anddyspnea . Both these conditions should be recognized too soon in the course of the disease to alleviate appropriate treatment for both the conditions .
Since , there is an intimate kinship between both myasthenia gravis and psychiatric symptoms ; there should be further survey to help in understand their recounting well that would improve the quality of life during the course of the disease .
Risk Factors For Myasthenia Gravis
Myasthenia gravis can be triggered or aggravate by many factors , such as surgery , stress , immunization , infection , lovesome weather , period , pregnancy , and worsening of medical condition , such as cardiac , nephritic or autoimmune diseases . Certain medications have played an significant role in aggravating or precipitate the disease . These admit penicillamine , anticholinergic drug , ketamine , diazepam , halothane , Cipro , aminoglycosides , ampicillin , clindamycin , phenytoin , lithium , propranolol , verapamil , timolol , tubocurarine , vecuronium , procainamide , magnesium , quinidine , chloroquine , phenothiazines , chlorpromazine and procainamide .
Clinical Presentation Of Myasthenia Gravis
The most common symptom associated with myasthenia gravis is helplessness without any pain in the ass . However , pain subsequent to muscle mental strain may be noted . The hallmark of the disease is that the impuissance is exacerbated with repeated use of sinew lead to increase weariness . Therefore , the symptom are regretful in the evening and best in the morning time of day .
The most commonly involve muscles are the eye muscles leading to droopy palpebra and double vision that progress from mild to severe over weeks to months . Bulbar symptoms include the oropharynx musculature leading to their weakness that affects jaw , swallowing , speech communication and external respiration . Difficulty chewing increase the chances of dream of nutrient and aspirationpneumonia . In some patient breathing problems may make respiratory failure . Skeletal muscles that are affected are basically the proximal muscles that assist in sit down , getting up from a president , walking , climbing step .
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