geoscience.net logo
+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Diagnostic challenge: Myasthenia gravis in the emergency department


, : Diagnostic challenge: Myasthenia gravis in the emergency department. Journal of the American Academy of Nurse Practitioners 22(9): 468-473

To describe an instructive case of neurological disease encountered by a nurse practitioner (NP) student in the emergency department (ED). Characteristics, epidemiology, pathophysiology, diagnostic considerations, and appropriate testing options for myasthenia gravis (MG) are included. Findings from the history, physical examination, and diagnostic testing of a 41-year-old male with neck weakness and pain. Review of published literature about MG. MG is a pure motor syndrome characterized by fluctuating muscle weakness and fatigue and is exacerbated by sustained muscle use. It is usually caused by an autoimmune process that is chronic and progressive. Multiple patient encounters with the healthcare system often occur prior to diagnosis. Many viable treatment options now exist that can enhance quality of life and improve function. The NP must include MG in the differential diagnosis with any report of fluctuating muscle weakness or other neurological, upper gastrointestinal, respiratory, or ophthalmic complaint. The key diagnostic finding is a specific muscle weakness that can be reproduced and exacerbated with sustained muscle use. These considerations will lead to earlier diagnosis and treatment.

US$19.90

PMID: 20854638

DOI: 10.1111/j.1745-7599.2010.00541.x


Other references

Gerrits, A.; Walasek, M.A.; Olthof, S.; Weersing, E.; Ritsema, M.; Zwart, E.; van Os, R.; Bystrykh, L.V.; de Haan, G., 2012: Genetic screen identifies microRNA cluster 99b/let-7e/125a as a regulator of primitive hematopoietic cells. Hematopoietic stem/progenitor cell (HSPC) traits differ between genetically distinct mouse strains. For example, DBA/2 mice have a higher HSPC frequency compared with C57BL/6 mice. We performed a genetic screen for micro-RNAs that are differential...

Pimley, RW., 1986: Toxicity of chlordimeform to the tsetse fly Glossina morsitans. The toxicity of chlordimeform against Glossina morsitans was assessed in the laboratory by topical application. The insecticide was toxic to both males and females with a maximum effect 72 h after treatment. The median lethal doses were approximat...

Gadaleta M.N.; Saccone C., 1974: Effect of rifampicin on macro molecular synthesis in rat liver mitochondria. Kroon, A M And C Saccone (Ed ) The Biogenesis Of Mitochondria: Transcriptional, Translational And Genetic Aspects Symposium Xxii+551p Illus Academic Press, Inc : New York, N Y , U S A ; London, England 85-88

Zondervan, K.T.; Yudkin, P.L.; Vessey, M.P.; Dawes, M.G.; Barlow, D.H.; Kennedy, S.H., 1999: Prevalence and incidence of chronic pelvic pain in primary care: Evidence from a national general practice database. Objectives: To estimate the prevalence and incidence in primary care of chronic pelvic pain in women in the UK. Design: Cross-sectional analysis of MediPlus UK Primary Care Database. Setting: One hundred and thirty-six general practices in the UK....

Derek Cheung, Y.Tak.; Spittal, M.J.; Williamson, M.Kate.; Tung, S.Jay.; Pirkis, J., 2015: Predictors of suicides occurring within suicide clusters in Australia, 2004-2008. A number of studies have investigated the presence of suicide clusters, but few have sought to identify risk and protective factors of a suicide occurring within a cluster. We aimed to identify socio-demographic and contextual characteristics of s...

Welborn, B.Locke.; Lieberman, M.D., 2015: Person-specific theory of mind in medial pFC. Although research on theory of mind has strongly implicated the dorsomedial pFC (incuding medial BA 8 and BA 9), the unique contributions of medial pFC (MPFC; corresponding to medial BA 10) to mentalizing remain uncertain. The extant literature ha...

VandeVord, P.J.; Wooley, P.H.; Darga, L.L.; Severson, R.K.; Wu, B.; Nelson, D.A., 2006: Genetic determinants of bone mass do not relate with breast cancer risk in US white and African-American women. The association between high bone mass and increased breast cancer risk has been established. Identification of polymorphisms and the resultant variant receptors suggests the possibility of differential effects on hormone responsive genes when com...

Lopez Rivas A.; Rozengurt E., 1984: Vasopressin rapidly stimulates calcium ii efflux from intracellular pool in quiescent swiss 3t3 cells. Addition of the neurohypophyseal nonapeptide [Arg8]vasopressin to 45Ca2+-loaded quiescent cultures of Swiss 3T3 cells or diploid mouse embyro fibroblasts causes a rapid increase (within seconds) in the rate of 45Ca2+ efflux from the cells. This re...

Filion, M.; Harnois, C., 1978: A comparison of projections of entopeduncular neurons to the thalamus, the midbrain and the habenula in the cat. Anatomical studies have demonstrated that the output of the striopallidal system is distributed to two areas of the thalamus: the ventrolateral-ventroanterior and the centromedian nuclei. The two areas are involved in different ways in the control...

Pérez-Miravete, A.; Romo Rodríguez, E., 1968: Immunologic response to natural and experimental Listeria monocytogenes infection. Revista Latinoamericana de Microbiologia Y Parasitologia 10(1): 21-32