Muscular diseases ppt课件


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简略标题:Muscular diseases




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Muscular diseases ppt课件内容预览:Fluctuating weaknessImproved by inhibitors of cholinesteraseEtiology andPathogenesisRelated to destructive effects of autoantibodies toAChREvidence:1. Experimental immunization of animals with purified AChR from an electric fish,induces high titers of antibody to the receptor.2. Human serum antibodies that react with human AChR were found in MG patients3.Electrophysiologic features of MG were produced by passive transfer of human IgG to mice.4. Plasmapheresis rced plasma levels of anti-AChR and ameliorated myasthenic symptoms and signs.How the autoimmune disorder starts is not known.In human MG,hyperplasia of the thymusabout 1516036050f cases is a thymoma.AChR antibodies are synthesized by B cell of hyperplastic thymus gland.When human myasthenic thymus was transplanted into mice,the animal produced antibodies to AChR that bound to their own motor end-plates.Pathologyppt2) The distribution of weakness:A. Ocular muscles are affected first in about 4020100240f the cases (Ptosis and diplopia).B. Affected facial oropharyngeal muscles (dysarthria,dysphagia and limination of facial movements).C. Limb and neck weakness.Crisis:occur in:oropharyngealrespiratory muscle weakness.provoked by:respiratory infectionsurgical procresemotional stresssystemic illness(3). Complete ophthalmoplegia in one or both eyes (diplopia). The pupil is never involved.(4). Weakness of oropharyngeal or limb muscles,and respiratory muscle.(5). Sensation is normal and the reflexes are preserved.Laboratory testsDifferential diagnosis:1.Botulism:presynaptic blocker of acetylcholine releasecaused by contaminate foodsprogressive muscle weaknessBeginning:extraocularpharyngeal musclesTreatment:trivalent antitoxinguanidine hydrochloride2. Lambert-Eaton syndrome(LEMS):Myasthenia-like syndrome occurs with carcinomaGeneralized muscle weaknessThe EMG is helpful in differentiating the syndrome from true myasthenia gravis.Treatment with removal of the tumor and guanidine hydrochloride.(2). Low-dose corticosteroid therapy:prednisone 25mg,qod,gradually increasing the dosage by 12.5mg every week until the total dosage reaches 100mg on alternate days.Immunotherapy(1). Azathioprine,50-100mg,twice a day.(2). Cyclophophamide 100mg,twice a day.6. Treatment of crisis(1). Myasthenic crisis:need assisted ventilationabout 10573f myasthenic patients occur,occur in patients with dysarthria,dysphagia,respiratory muscle weakness,respiratory infection,and major surgerycaused by less anticholinesterase drugs dosage.
课件关键字:Muscular diseases ,Muscular,di。

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