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Disorder of NeuroMuscular Transmission

Myasthenia Gravis

  1. It is neuro muscular disorder characterized by weakness and fatigability of skeletal muscles. The underlying defect is decreased number of available Ach receptors is due to circulating receptor-binding antibodies.
  2. Although Ach is released normally failure of transmission at many neuromuscular junctions resulting in weakness of muscle contraction.
  3. Infants born to myasthenic mothers may have a transient neonatal myasthenic syndrome secondary to placentally transferred Anti Ach receptor antibodies, distinct from congenital myasthenia gravis. Q 

Clinical Manifestations

  1. Ptosis and some degree of extra ocular muscle weakness are the earliest and most constant signs in myasthenia gravis.
  2. Papillary reflex of light are preservedQ. Dysphagia and facial weakness are also common.
  3. Rapid fatigue of muscle is a characteristic featureQ
  4. Fasciculation of muscle, myalgia, and sensory symptoms do not occur. 

Laboratory findings

  1. MG is one of the few neuromuscular disease in which an electromyogram (EMG) is more specifically diagnostic than a muscle biopsy. Q
  2. Anti Ach antibodies should be assayed in the plasma
  3. Muscle biopsy limited value
  4. Clinical test – short acting cholinesterase inhibitor usually edrophonium. 


  1. Cholinesterase inhibiting drug              
  2. Steroid
  3. Thymectomy                        
  4. IVIG            
  5. Plasmapheresis

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