MYASTHENIC SYNDROMES
Myasthenia gravis is an autoimmune disease
characterized by autoantibodies against the acetylcholine
(ACh) receptor of the neuromuscular junction, resulting in muscular weakness
predominantly affecting the facial muscles. Females are affected more
frequently than males.
•
Extraocular muscle weakness may lead to ptosis and diplopia; the
weakness worsens with repeated contractions.
•
Respiratory muscle involvement may lead to death.
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There is an association with thymic hyperplasia and thymomas.
Treatment is
anticholinesterase agents, steroids, and thymectomy.
Lambert-Eaton myasthenic syndrome frequently arises before a
diagnosis of cancer is made, often in cases of
small cell lung cancer. Patients report dry mouth and proximal muscle weakness.
Autoantibodies are directed against presynaptic calcium channels of the
neuromuscular junction. Treatment is immunotherapy and cancer treatment, if
indicated.
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