MICRO
CNS (1).pptx

Patients with ocular mg will never give clinical

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Patients with ocular MG will never give clinical signs and symptoms that indicate involvement of other muscles. These patients do not have difficulty swallowing, speaking or breathing nor do they have weakness of the arms or legs. 394
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Patients with predominantly ocular features and negative antibody seems to be a case of ocular myasthenia gravis. Occular myasthenia gravis is characterized by a triad of:- - Ptosis - Diplopia - Orbicularis occuli weakness 395
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The patient in the question gives features of generalized myasthenia too i.e., difficulty in chewing and swallowing. - These symptoms indicate bulbar involvement. - Absence of antibodies are more common with ocular myasthenia gravis but can also occur with generalized myasthenia gravis. 396
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Patients with generalized myasthenia gravis can be seronegative in some cases. - The term seronegative myasthenia gravis also called antibody negative myasthenia gravis refer to 6-12% of patients. - The term was previously used only for those who were AchR antibody negative , regardless of musk antibody status. 397
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A 50-year-old male presented with complaints of ptosis, difficulty in chewing and occasional difficulty in swallowing. There is no h/o diplopia or visual loss. On examination, there is asymmetric ptosis and mild restriction of exraocular muscle movement with finger abduction test 600. Nerve conduction study shows decremental response in orbicularis only. ERG revealed a myopathic pattern. Anti AChR radioimmunoassay was negative. The most probable diagnosis would be - (AIIMS May 13) a) Ocular myasthenia gravis b) Generalized myasthenia gravis c) As the Anti-AChR radioimmunoassay is negative, you will consider an alternative diagnosis d) Chronic external Ophthalmoplegia B 398
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The most sensitive test for the diagnosis of myasthenia gravis is - (AI 05) a) Elevated serum ACH-receptor binding antibodies b) Repetitive nerve stimulation test c) Positive edrophonium test d) Measurement of jitter by single fibre electromyography 399
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401
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The most sensitive test for the diagnosis of myasthenia gravis is - (AI 05) a) Elevated serum ACH-receptor binding antibodies b) Repetitive nerve stimulation test c) Positive edrophonium test d) Measurement of jitter by single fibre electromyography D 402
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Ice pack test is due for - (NBE/DNB Pattern) a) Myesthenia gravis b) Multiple system atrophy c) Hyperparathyroidism d) Hypokalemic periodic paralysis A 403
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Drug of choice for myasthenia gravis (PG1 Dec 99) a) Gallamine b) Succinylocholine c) D. tubocurare d) Pyridostigmine. 404
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The treatment of this disease involves the careful use of two groups of drugs:- A) Anticholinesterases i) Neostigmine ii) Pyridostigmine Pyridostigmine is the more prefered drug. It is the t/t of choice for myaesthenia gravis.
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  • Winter '16
  • jean grey

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