Anti-crisis

Introduction Ruminant crisis is a serious complication of patients with myasthenia gravis, mainly seen in patients with systemic myasthenia gravis, mostly after thymoma resection. Brittle crisis: The dose of the cholinesterase inhibitor has not changed, but suddenly the drug has failed and severe breathing difficulties have occurred.

Cause

The predisposing factors are: infection; trauma, childbirth, thymectomy or radiotherapy, treatment or improper treatment or sudden withdrawal, the effects of certain drugs, such as arrow poison, morphine. The patient suddenly fails to take the drug during the administration of cholinergic and/or steroid drugs, causing the patient to have generalized muscle weakness, especially a series of serious life-threatening symptoms such as respiratory muscle paralysis and dyspnea.

an examination

Related inspection

Thoracic chest CT examination

1.1 New Tests. 2 Tengxilong test, because the effect disappeared after 20 minutes, the use is safer. Dissolve 10 mg in 10 ml of normal saline, first intravenously inject 2 mg, and then inject 8 mg without discomfort. After a few minutes, the muscle weakness first improved and the worsened muscle weakness, the symptom aggravated was a cholinergic crisis, and the unimproved one was a ruminant crisis.

2. Electrophysiological examination: continuous induction of electrical stimulation, damage to the muscles and rapid disappearance.

3. Others: About 85% of patients with anti-AChRab in serum have elevated chest X-ray or thymus CT, thymic hyperplasia or thymic tumor, and have diagnostic value.

Differential diagnosis

Other symptoms of myasthenia gravis crisis:

Myasthenia gravis

That is to say, the new sin is not dangerous, often caused by infection, trauma, and reduction. Respiratory muscle paralysis, cough, swallowing, and life-threatening.

2. Cholinergic crisis

That is, the new period of the excessive crisis. In addition to the aforementioned muscle weakness crisis, there are symptoms of excessive accumulation of acetylcholine:

1 muscarinic poisoning: nausea, vomiting, diarrhea, abdominal pain, small pupil, sweating, runny nose, tracheal secretions, slow heart rate,

2 niacin-like poisoning symptoms: muscle tremor, convulsions, tight feeling,

3 central nervous symptoms: anxiety, insomnia, mental confusion and so on.

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