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Ch 5: Myasthenia Gravis

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Myasthenia Gravis Etiology:
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The disease is caused by an autoimmune attack on the acetylcholine receptor of the postsynaptic neuromuscular junction
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Myasthenia Gravis Diagnosis:
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Characterized by episodic muscle weakness, chiefly in muscles innervated by cranial nerves.
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Myasthenia Gravis Symptoms:
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• ptosis, diplopia, muscle fatigue after exercise, dysarthria, dysphasia, and proximal limb weakness. • Symptoms fluctuate during the course of the day • In relapsing periods, quadriparesis may develop. • Life threatening respiratory muscle involvement may occur.
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Medical management: Myasthenia Gravis
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• Cholinesterase inhibitors, corticosteroids, immunosuppressant agents, and plasmapherisis
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Myasthenia Gravis OT evaluation:
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• Occupational Profile • COPM • Performance skills in areas of occupation: ADLs, IADLS, education, work, play, social participation. • Performance pattern: activity log • Client factors: MMS, ROM, eating and swallowing assessments, pain scale, depression scale, ways of coping scale and clinical observation during activities. • Activity demands
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Myasthenia Gravis OT intervention:
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• MSM must be monitored on a regular basis, and the OT documents any changes. • Effective self-care actions includes stress reduction techniques, pacing all activities, and increase rest and sleep. • Patient / family education to use energy conservation and work simplification strategies during ADls, IADLs and leisure activities. • Adaptive and assistive devices may be introduced to decrease effort during daily activities. • OT should visit the client’s home to assess architectural barriers, bathroom safety, and furniture arrangements, due to impaired vision.