Skip to main content

Myasthenia Gravis, Emergency Medicine

Reviewed 06/2017
 


Basics

Description

  • Antibody-mediated condition that results in painless, fatigable muscle weakness

  • Ocular or generalized:

    • Ocular (eyelids and extraocular) muscle weakness:

      • Most common initial symptom (60%...

Diagnosis

Signs and Symptoms

Fluctuating focal weakness 

History

  • Symptoms worsen with repeated activity:

    • Improve with rest

  • Ocular weakness:

    • Diplopia

    • Ptosis while driving or reading

  • Bulbar and facial muscle we...

Treatment

Pre-Hospital

Attention to airway management 

Initial Stabilization/Therapy

Myasthenic crisis: 
  • Most important is early intubation and mechanical ventilation.

  • Signs of impending failure:

    • Vital capa...

Follow-Up

Disposition

Admission Criteria

  • New-onset myasthenic symptoms

  • Diagnosis unclear, but myasthenia a possibility

  • Myasthenic patients with worsening symptoms

  • Myasthenic crisis or questionable respirat...

Pearls and Pitfalls

  • Search for signs of myasthenic crisis in any MG patient who presents to the ED.

  • Search carefully for secondary conditions in patients with worsening MG.

  • Place patient on cardiac moni...

Additional Reading

  • Bershad  EM, Feen  ES, Suarez  JI. Myasthenia gravis crisis. South Med J.  2008;101:63–69.

  • Conti-Fine  BM, Milani  M, Kaminski  HJ. Myasthenia gravis: Past, present and future. ...

Codes

ICD9

  • 358.00 Myasthenia gravis without (acute) exacerbation

  • 358.01 Myasthenia gravis with (acute) exacerbation

  • 775.2 Neonatal myasthenia gravis

  • 358.0 Myasthenia gravis

ICD10

  • G70.00 Myasthenia gravis wi...

Subscribe to Access Full Content

Sign Up for a 10-Day Free Trial

Sign up for a 10-day FREE Trial now and receive full access to all content.

×