Changes

=Neuromuscular Junction=

=Neuromuscular Junction=

==Myasthenia Gravis==

==Myasthenia Gravis==

*H&P: Autoantibodies against AChR, presents with muscle weakness that worsens as the day progresses and improves after sleep. May have positive family history.

*H&P: Autoantibodies against AChR, presents with muscle weakness that worsens as the day progresses and improves after sleep. May have positive family history. May have thymoma.

*Dx: Look for ptosis that improves with ice pack test. Edrophonium test is positive. EMG shows unstable baseline between APs.

*Dx: Look for ptosis that improves with ice pack test. Edrophonium test is positive. EMG shows unstable baseline between APs.

*Tx: 1st line Pyridostigmine. 2nd line steroids or immunomodulating meds (e.g. cyclosporine, azathioprine). Plasmapheresis or IVIG for myasthenia crisis. Thymectomy may reduce symptoms and exacerbations.

*Tx: 1st line Pyridostigmine. 2nd line steroids or immunomodulating meds (e.g. cyclosporine, azathioprine). Plasmapheresis or IVIG for myasthenia crisis. Thymectomy may reduce symptoms and exacerbations.