By

Ms. Snehal Patil

Neuro transmission:

Definition :

It is a chronic autoimmune neuromuscular disease characterized by varying degree of weakness of skeletal muscles of the body.

It is purely a motor disorder with no effects on sensation and co-ordination.

Etiology : Genetic

Abnormality of thymus gland

Thymic hyperplasia

Women at earlier age (20-40 years)

Men at older age (60-70 years)

Classification :

Pathophysiology :

Ocular symptoms:Ptosis Diplopia

Nystagmus

Dysarthia

Weakness of muscles of face and throat

Bland facial expression Dysphonia

Intercostal muscle weakness

Generalized weakness

Diagnostic Test : Anticholinesterase test :

normal value – 0.0 to 0.25 nmol/L

Endrophonium chloride test:

endrophonium chloride (tensilon) 2mg to 10 mg intravenously

Repetative nerve stimulation test

MRI for thymus gland enlargement

Medical management : Pharmacological therapy:

Pyridostigmine bromide (anticholinesterasemedication)

Immunosuppresive therapy

Cytotoxic medications

Azathioprine {T lymphocyte inhibitor}

IVIG (Intravenous immune globulin)

Plasmapheresis:

Surgical Management : Thymectomy

Nursing management : Assessment – neurological examination

- extent of respiratory involvement

Assistance in activities of daily living

Nutrition through eternal route

Aspiration precautions

Skin care

Effective method of communication

Nursing diagnosis : Ineffective breathing pattern related to respiratory

muscle weakness

Ineffective airway clearance related to tracheal secretions

Impaired physical mobility related to weakness of voluntary muscle

Imbalanced nutrition less than body requirement related to dysphagia, intubation or muscle paralysis

Risk for aspiration related to weakness of bulbar muscle

Self care deficit related to muscle weakness

Risk for infection related to immunosupressive status or multiple invasive lines