Myasthenia Gravis
Background
Myasthenia gravis is a Type II autoimmune disorder in which antibodies form against various types of receptors, kinases, or proteins (1). There are four subtypes of myasthenia gravis, with the most prevalent subtype being due to autoantibodies against the muscle-type acetylcholine receptor, AChR, at the neuromuscular junction (2; 3). The second subtype involves antibodies against the muscle-specific kinase, MuSK, and the third type is due to autoantibodies against the agrin-receptor low-density lipoprotein receptor-related protein 4, LRP 4. Finally, the fourth type of myasthenia gravis has autoantibodies against other muscle endplate proteins. There is a strong association of increased risk for myasthenia gravis …show more content…
The ocular form is considered the initial stage of the disease, and it will progress into a more generalized form of the disorder. There are five classes of the disorder. Classes two through four have two subclasses, which express what specific muscle groups are involved; subclass a focuses or limb and axial muscles, whereas class b involves oropharyngeal and respiratory muscles. Class I of myasthenia gravis states that the patient only has ocular weakness of any severity. Class II is defined as having mild weakness of muscles other than ocular muscles along with ocular weakness of any severity. Class III is defined as moderate weakness of muscles, excluding ocular muscles, along with ocular weakness of any severity. Class IV is severe weakness of muscles, once again excluding ocular muscles and ocular weakness of any severity. Class IVb can also require feeding tube usage without intubation due to weakness of the oropharyngeal and respiratory muscles. Finally, Class V is the final stage of the disorder, and it is defined by the need for intubation, with or without mechanical …show more content…
Myasthenia is a combination of the two Latin words for muscle and weakness, and gravis in Latin means severe (6). The first case of myasthenia gravis might have been described in 1664. There was a Native American named Chief Opechancanough who died in 1664 after experiencing excessive fatigue and macerated flesh. The observers also noted that his sinews lost tone and elasticity and that the chief could not see unless his eyelids were lifted up by his attendants. It was also noted that the chief was unable to walk. An English physician, Thomas Willis, described the next possible case of myasthenia gravis in 1672. He noted that his patient had “fatigable weakness” of the limbs and bulbar
Background
Myasthenia gravis is a Type II autoimmune disorder in which antibodies form against various types of receptors, kinases, or proteins (1). There are four subtypes of myasthenia gravis, with the most prevalent subtype being due to autoantibodies against the muscle-type acetylcholine receptor, AChR, at the neuromuscular junction (2; 3). The second subtype involves antibodies against the muscle-specific kinase, MuSK, and the third type is due to autoantibodies against the agrin-receptor low-density lipoprotein receptor-related protein 4, LRP 4. Finally, the fourth type of myasthenia gravis has autoantibodies against other muscle endplate proteins. There is a strong association of increased risk for myasthenia gravis …show more content…
The ocular form is considered the initial stage of the disease, and it will progress into a more generalized form of the disorder. There are five classes of the disorder. Classes two through four have two subclasses, which express what specific muscle groups are involved; subclass a focuses or limb and axial muscles, whereas class b involves oropharyngeal and respiratory muscles. Class I of myasthenia gravis states that the patient only has ocular weakness of any severity. Class II is defined as having mild weakness of muscles other than ocular muscles along with ocular weakness of any severity. Class III is defined as moderate weakness of muscles, excluding ocular muscles, along with ocular weakness of any severity. Class IV is severe weakness of muscles, once again excluding ocular muscles and ocular weakness of any severity. Class IVb can also require feeding tube usage without intubation due to weakness of the oropharyngeal and respiratory muscles. Finally, Class V is the final stage of the disorder, and it is defined by the need for intubation, with or without mechanical …show more content…
Myasthenia is a combination of the two Latin words for muscle and weakness, and gravis in Latin means severe (6). The first case of myasthenia gravis might have been described in 1664. There was a Native American named Chief Opechancanough who died in 1664 after experiencing excessive fatigue and macerated flesh. The observers also noted that his sinews lost tone and elasticity and that the chief could not see unless his eyelids were lifted up by his attendants. It was also noted that the chief was unable to walk. An English physician, Thomas Willis, described the next possible case of myasthenia gravis in 1672. He noted that his patient had “fatigable weakness” of the limbs and bulbar