MS- NEURO- DEGENERATIVE DISEASES

• Myasthenia gravis is an autoimmune disorder affecting the myoneural junction, characterized by varying degrees of weakness of the voluntary muscles
• Incidence of myasthenia gravis in the United States is between 9 and 30 in 1 million people, occurring more often in women during the second and third decades of life and more common in men after age 50
• Multiple Sclerosis (MS) is an immune-mediated, progressive demyelinating disease of the CNS, resulting in impaired transmission of nerve impulses due to the destruction of myelin
• Parkinson's Disease is a movement disorder characterized by a decline in dopamine levels in the brain, leading to loss of motor control, tremors, rigidity, and akinesia
• Guillain-Barre Syndrome (GBS) is a rare lower motor neuron disorder where the immune system mistakenly attacks part of the peripheral nervous system, resulting in flaccid paralysis
• In Myasthenia gravis, the immune system produces antibodies that block or destroy the binding of acetylcholine, leading to fewer nerve signals and muscle weakness
• Demyelination in Multiple Sclerosis causes communication issues between the brain and the rest of the body, resulting in permanent nerve damage
• Clinical manifestations of Myasthenia gravis include weakness, eyelid drooping, appearance changes, choking/gagging, lack of energy, extraocular movements, slurred speech, and shortness of breath
• Hallmark signs of Myasthenia gravis include Charcot's triad: nystagmus, bending/forwarding tilt, shuffling gait, mask-like face, akinesia, rigidity, and tremor
• Common tests for Myasthenia gravis include acetylcholinesterase inhibitor test, MRI, electrophoresis of CSF, urodynamic studies, neuropsychological tests, motor tests, smell tests, dopamine transporter scan, cognitive tests, spinal tap, electromyography, nerve conduction studies, and CSF analysis
• Medical management for Myasthenia gravis focuses on controlling symptoms and maintaining functional independence, with treatments like anticholinesterase medications, corticosteroids, immunosuppressants, plasmapheresis, IVIG, and mechanical ventilation if needed
• Nursing management for Myasthenia gravis includes providing large meals in the morning, activities in the morning, thick liquids, small bites, assessing swallowing, vision changes, vital signs, and monitoring for falls, aspiration, and respiratory effort
• Surgical management for Myasthenia gravis may involve thymectomy, thalamotomy, pallidotomy, deep brain stimulation (DBS), or neural transplantation
• Complications of Myasthenia gravis include myasthenic crisis, urinary tract infections, constipation, pressure ulcers, contractures, deformities, spasticity, edema, pneumonia, and depression
• Symptoms of Guillain-Barre Syndrome include ascending symmetrical muscle weakness, neuromuscular respiratory failure, absent deep-tendon reflexes, and lower extremity weakness
• Complications of Guillain-Barre Syndrome include paresthesia leading to paralysis, urinary tract infections, constipation, pressure ulcers, contractures, deformities, spasticity, edema, pneumonia, and depression
• Cholinergic Crisis, a rare complication, is caused by overmedication with cholinesterase inhibitors, leading to severe generalized muscle weakness and respiratory or bulbar weakness
• Both Myasthenic Crisis and Cholinergic Crisis can result in respiratory compromise and failure, requiring interventions like intubation or mechanical ventilation
• Lewy bodies are found in the substantia nigra in Parkinson's disease
• Parkinson's disease is characterized by tremors, rigidity, bradykinesia, postural instability
• Parkinsonism refers to symptoms similar to those seen in PD but not necessarily due to PD
• Dopamine agonists (e.g., pramipexole) are used as first line treatment for early stage PD
• Deep brain stimulation (DBS) involves implanting electrodes into specific areas of the brain to regulate abnormal electrical activity associated with movement disorders such as dystonia and parkinsonism.