A 35 year old female patient presents with proximal weakness of muscles, ptosis and easily fatiguability. September 2011
Ans. D: Edrophonium test The intravenous injection of the sho acting anticholinesterase, edrophonium bromide, is a valuable diagnostic aid (the tensilon test) for myasthenia gravis Myasthenia gravis/ MG: A disease characterized by episodic muscle weakness, chiefly in muscle innervated by cranial nerves and characteristically improved by anti-cholinesterase inhibiting drug There is decreased myoneural junction transmission due to auto-immune attack on the acetylcholine receptor of the post-synaptic neuromuscular junction, which results in loss of dysfunction of Ach receptors and jeopardizing normal neuromuscular transmission Dysahria, dysphagia and proximal limb weakness is common Sensory modalities and deep tendon reflexes are normal Pyridostigmine/ Neostigmine are the MC used cholinergic drugs Thymectomy is indicated in all patients with generalized MG Plasmapheresis may be useful for preparing refractory cases fro thymectomy and during respiratory crisis
Muscle biopsy
CPK levels
EMG
Edrophonium test