{"id":2552,"date":"2009-03-02T02:21:52","date_gmt":"2009-03-02T02:21:52","guid":{"rendered":"https:\/\/medicalcriteria.com\/web\/neuromg\/"},"modified":"2025-05-14T19:11:27","modified_gmt":"2025-05-14T19:11:27","slug":"neuromg","status":"publish","type":"post","link":"https:\/\/medicalcriteria.com\/web\/neuromg\/","title":{"rendered":"Diagnostic Criteria for Myasthenia Gravis"},"content":{"rendered":"<div class=\"99c380e4b4a7b96c35d7ddf7dcb434e8\" data-index=\"1\" style=\"float: none; margin:0px 0 0px 0; text-align:center;\">\n<script async src=\"https:\/\/pagead2.googlesyndication.com\/pagead\/js\/adsbygoogle.js\"><\/script>\r\n<!-- MC 2019- Horizontal -->\r\n<ins class=\"adsbygoogle\"\r\n     style=\"display:block\"\r\n     data-ad-client=\"ca-pub-0127150553352455\"\r\n     data-ad-slot=\"3806776041\"\r\n     data-ad-format=\"auto\"\r\n     data-full-width-responsive=\"true\"><\/ins>\r\n<script>\r\n     (adsbygoogle = window.adsbygoogle || []).push({});\r\n<\/script>\n<\/div>\n<p><\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\">Neuromuscular transmission disorder characterized by fluctuating weakness and fatigability of bulbar and other voluntary muscles without loss of reflexes or impairment of sensation or other neurologic function.<\/p>\n<p><!--more--><\/p>\n<p class=\"MsoNormal\"><em>Diagnostic criteria:<\/em><\/p>\n<p class=\"MsoNormal\">A. Characteristic signs and symptoms<\/p>\n<p class=\"MsoNormal\">One or more of the following:<\/p>\n<ol>\n<li class=\"MsoNormal\">Diplopia, ptosis, dysarthria, weakness in chewing, difficulty in swallowing, muscle weakness with preserved deep tendon reflexes, and, less commonly, weakness of neck extension and flexion, and weakness of trunk muscles<\/li>\n<li class=\"MsoNormal\">Increased weakness during exercise and repetitive use with at least partially restored strength after periods of rest<\/li>\n<li class=\"MsoNormal\">Dramatic improvement in strength following administration of anticholinesterase drug (edrophonium (Tensil\u00f3n\u00ae) and neostigmine);<\/li>\n<\/ol>\n<p class=\"MsoNormal\">and one or more of the following:<\/p>\n<p class=\"MsoNormal\">B. EMG and repetitive stimulation of a peripheral nerve: In myasthenia gravis repetitive stimulation at a rate of 2 per second shows characteristic decremental response which is reversed by edrophonium or neostigmine. Single fiber studies show increased jitter.<\/p>\n<p class=\"MsoNormal\">C. Antibodies to Acetylcholine Receptors<\/p>\n<p class=\"MsoNormal\"><em>Exclusions:<\/em><\/p>\n<ul>\n<li class=\"MsoNormal\">Congenital myasthenic syndrome, progressive restricted myopathies, steroid and inflammatory myopathies, motor neuron disease<\/li>\n<li class=\"MsoNormal\">Multiple sclerosis, variants of Guillain-Barr\u00e9 syndrome (e.g., Miller-Fisher syndrome)<\/li>\n<li class=\"MsoNormal\">Organophosphate toxicity, botulism, black widow spider venom<\/li>\n<li class=\"MsoNormal\">Eaton-Lambert syndrome<\/li>\n<li class=\"MsoNormal\">Stroke<\/li>\n<li class=\"MsoNormal\">Medications: neuromuscular blocking agents, aminoglycosides, penicillamine, antimalarial drugs, colistin, streptomycin, polymyxin B, tetracycline<\/li>\n<li class=\"MsoNormal\">Hypokalemia; hypophosphatemia<\/li>\n<\/ul>\n<p class=\"MsoNormal\"><strong>Severity (Osserman classification):<\/strong><\/p>\n<ul>\n<li>I: Ocular myasthenia<\/li>\n<li>IIA: Mild generalized myasthenia with slow progression: no crises, responsive to drugs<\/li>\n<li>IIB. : Moderately severe generalized myasthenia : severe skeletal and bulbar involvement but no crises; drug response less than satisfactory<\/li>\n<li>III: Acute fulminating myasthenia, rapid progression of severe symptoms, with respiratory crises and poor drug response<\/li>\n<li>IV: Late severe myasthenia, same as III but progression over 2 years from class I to II<\/li>\n<\/ul>\n<\/div>\n<p>&nbsp;<\/p>\n<div class=\"Section1\">\n<p class=\"MsoNormal\"><strong>References:<\/strong><\/p>\n<\/div>\n<div>\n<ol>\n<li>Ossermann KE. Myasthenia gravis. New York: Grune and Stratton; 1958.<\/li>\n<li>Engel AG. Myasthenic syndromes. In: Engel AG, Franzini Armstrong C, editors. Myology. 2nd ed. New York: McGraw Hill; 1994. p. 1798-835.<\/li>\n<\/ol>\n<\/div>\n<p>&nbsp;<\/p>\n<p>Created: Oct 11, 2006<\/p>\n\n<div style=\"font-size: 0px; height: 0px; line-height: 0px; margin: 0; padding: 0; clear: both;\"><\/div>","protected":false},"excerpt":{"rendered":"<p>Sorry, this entry is only available in Espa\u00f1ol.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_lmt_disableupdate":"no","_lmt_disable":"no","_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"footnotes":""},"categories":[2],"tags":[16,15,14,13,1686,1687,1688,1300],"class_list":["post-2552","post","type-post","status-publish","format-standard","hentry","category-neurology","tag-criteria","tag-criterios","tag-diagnostic","tag-diagnostico","tag-gravis","tag-miastenia","tag-myasthenia","tag-neurology"],"modified_by":"Guillermo Firman","_links":{"self":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2552","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/comments?post=2552"}],"version-history":[{"count":3,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2552\/revisions"}],"predecessor-version":[{"id":9123,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/posts\/2552\/revisions\/9123"}],"wp:attachment":[{"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/media?parent=2552"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/categories?post=2552"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/medicalcriteria.com\/web\/wp-json\/wp\/v2\/tags?post=2552"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}