Powerless

Introduction Myasthenia gravis (DM) is a chronic autoimmune disease caused by dysfunction between nerves and muscle joints. The disease has a tendency to relieve and relapse, can occur at any age, but more often in children and adolescents, more women than men, and more men in later years. The clinical manifestation is that the affected striated muscle is prone to fatigue. This weakness is reversible. It can be recovered after rest or administration of anti-cholinesterase drugs, but it is easy to relapse.

Cause

Myasthenia gravis is the most well-characterized and most representative autoimmune disease in human diseases. It is the involvement of acetylcholine receptors on the postsynaptic membrane of neuromuscular junctions, and humoral immunity mediated by acetylcholine receptor antibodies. T cell-mediated cellular immune dependence, autologous disease involved in complement, thymus is an important factor in activating and maintaining autoimmune response to myasthenia gravis. Certain genetic and environmental factors are also closely related to the pathogenesis of myasthenia gravis.

(1) External factors - environmental factors

Clinically, certain environmental factors such as environmental pollution caused by decreased immunity; excessive fatigue caused by immune dysfunction; viral infection or the use of aminoglycoside antibiotics or D-penicillamine and other drugs to induce certain genetic defects.

(2) Internal cause - genetic

In recent years, many autoimmune diseases have found that they are not only related to major histocompatibility antigen complex genes but also to non-compatible antigen complex genes such as T cell receptors, immunoglobulins, cytokines, and apoptosis. related.

(3) Abnormal autoimmune system in patients with myasthenia gravis.

Clinical studies have found that many immune indicators in patients with this disease are abnormal. After treatment, the clinical symptoms disappeared but the abnormal immune indicators did not change. This may be an important factor for the unstable disease and easy recurrence of this disease.

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Myasthenia gravis is seen at any age, and about 60% occur before the age of 30, which is more common in women. The onset is often accompanied by thymoma. Except for a few onset and rapid deterioration, most of the onset of insidious attacks, the main symptom is that the skeletal muscles are tired after a little activity, and they will improve after a short break.

Symptoms are usually light in the morning and heavy, and can be varied. The course of disease is prolonged and can be relieved spontaneously. Colds, emotional excitement, overwork, menstrual cramps, use of anesthesia, sedative drugs, childbirth, surgery, etc. often relapse or aggravate the condition. All striated muscles of the whole body can be affected, and the distribution of affected muscles varies from person to person. The muscles innervated by cranial nerves, especially the extraocular muscles, are most likely to be involved, often as early or only symptoms; light eye movements are involved, mostly asymmetrical eyelids Drooping, blinking weakness, strabismus, diplopia, and sometimes eyelid sag alternately; heavy eyes are fixed. Late systemic patients may have atrophy of the scapular muscle, biceps, deltoid and quadriceps.

Differential diagnosis

Need to be identified with the following symptoms:

Pulse speed and weakness: When the Chinese medicine pulse (touch pulse), such as pulse (heartbeat) jumps quickly, called the fast pulse (normal 72 times / min); pulse weakness refers to the weaker than normal people. Pulse speed and weakness means that the pulse beat frequency is fast and the beat is weak. Usually caused by excessive bleeding.

Myasthenia gravis: Myasthenia gravis refers to a sudden increase in myasthenia gravis, respiratory muscles, swallowing muscles, progressive weakness or paralysis, and life-threatening. Muscle weakness crisis: that is, Xin Si Ming is not a crisis, often caused by infection, trauma, and reduction. Respiratory muscle paralysis, cough, swallowing, and life-threatening.

Symmetrical muscle weakness: Progressive muscular dystrophy is a group of primary muscle degeneration diseases characterized by aggravation of symmetrical muscle weakness, muscle atrophy, and hereditary disease. Duchenne (DMD) and Becker (BMD), two X-linked recessive hereditary muscular dystrophy, have been studied in progressive muscular dystrophy.

Myasthenia gravis is seen at any age, and about 60% occur before the age of 30, which is more common in women. The onset is often accompanied by thymoma. Except for a few onset and rapid deterioration, most of the onset of insidious attacks, the main symptom is that the skeletal muscles are tired after a little activity, and they will improve after a short break.

Symptoms are usually light in the morning and heavy, and can be varied. The course of disease is prolonged and can be relieved spontaneously. Colds, emotional excitement, overwork, menstrual cramps, use of anesthesia, sedative drugs, childbirth, surgery, etc. often relapse or aggravate the condition. All striated muscles of the whole body can be affected, and the distribution of affected muscles varies from person to person. The muscles innervated by cranial nerves, especially the extraocular muscles, are most likely to be involved, often as early or only symptoms; light eye movements are involved, mostly asymmetrical eyelids Drooping, blinking weakness, strabismus, diplopia, and sometimes eyelid sag alternately; heavy eyes are fixed. Late systemic patients may have atrophy of the scapular muscle, biceps, deltoid and quadriceps.

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