INTRODUCTION

Myasthenia gravis (MG) is a neuromuscular disorder that causes weakness in the skeletal
muscles, which are the muscles of the body uses for movement. It occurs when communication
between nerve cells and muscles becomes impaired. This impairment prevents crucial muscle
contractions from occurring, resulting in muscle weakness. MG is the most common primary
disorder of neuromuscular transmission.
MG is a neuromuscular disorder thats usually caused by an autoimmune problem.
Autoimmune disorders occur when your immune system mistakenly attacks healthy tissue. In
this condition, antibodies, which are proteins that normally attack foreign, harmful substances in
the body, attack the neurotransmitter substance acetylcholine, which is a crucial substance for
communication between nerve cells and muscles. This results in muscle weakness.
The main symptom of MG is weakness in the voluntary skeletal muscles, which are
muscles under control. The failure of muscles to contract normally occurs because they cant
respond to nerve impulses. Without proper transmission of the impulse, a blocked
communication occurs between nerve and muscle and weakness results. Weakness associated
with MG typically gets worse with more activity and improves with rest. Symptoms of MG can
include: trouble talking, problems walking up stairs or lifting objects, facial paralysis, difficulty
breathing because of muscle weakness, difficulty swallowing or chewing, fatigue, hoarse voice,
drooping of eyelids, double vision. Not everyone will have every symptom, and the degree of
muscle weakness can change from day to day. The severity of the symptoms typically increases
over time if left untreated.
Diagnosing MG has the following TEST: checking your reflexes, looking for muscle
weakness, checking for muscle tone, making certain your eyes move properly, testing sensation
in different areas of your body, testing motor functions, like touching your finger to your nose.
Other tests that can help your doctor diagnose the condition include: repetitive nerve stimulation
test, blood testing for antibodies associated with MG, edrophonium (Tensilon) test: A drug called
Tensilon (or a placebo) is administered intravenously, through a vein, and perform muscle
movements, imaging of the chest, using CT scans or MRI, to rule out a tumor.
With recent advances in understanding the various underlying antibodies that cause
myasthenia gravis and differences in how they present clinically and respond to various
therapies, it is suggested that patients with myasthenia gravis should be classified into subgroups.
Subgroups based on serum antibodies and clinical features may include early-onset, late-onset,
and patients with thymoma, MuSK, LRP4, antibody-negative, and ocular forms of myasthenia
gravis.
Therapy for MG includes the following:Anticholinesterase (AchE) inhibitors,
Immunomodulating agents, Intravenous immune globulin (IVIg), Plasmapheresis, Thymectomy
One of the most dangerous potential complications of MG is myasthenic crisis. This
consists of life-threatening muscle weakness that can include breathing problems. If you start to
have trouble breathing or swallowing, go to your local clinic or hospital immediately.
According to the Myasthenia Gravis Foundation of America, its a relatively rare
condition that affects between 14 and 20 out of every 100,000 people and most common in
women age 20-40, men age 50-70. And according to National Institutes of Health there is 4, 312
incidence in the Philippines, its rate approx 1 in 20,000. In the Medical Records Section of
Cagayan Valley Medical Center, there is a lone case of myasthenia gravis recorded during the
years of 2013, and 2014. However the number recorded increase to 3 during the year 2015.
While the number of cases recorded during the year of 2016 in MG increase to 5. And this year,
there is only one case recorded to date. Women have the most number of MGs case in CVMC

Significance of the study shall be beneficial to the following persons:

For the presenters, this is significant, as the presenters had the privilege to render care in
the ward. It will be the best way for them in enhancing critical thinking skills and it also
facilitates a better understanding on the concepts and theories.
For the audience, the audience will be given the privilege to ask relevant questions and
share their knowledge about the said disease not mentioned by the presenters for the purpose of
enhancing this work.

For Clinical Instructors, this presentation will provide a venue for the clinical instructors
to assess the presenters in terms of their knowledge, skills and attitude and for them to give
supplements regarding the topic.