DartmouthDave Posted May 4, 2011 Posted May 4, 2011 Hello, Myasthenia gravis is an autoimmune mediated attack on the Ach motor receptor. Manifests as weakness and fatigue. My knowledge of this condition is quite weak. I know that Sux is an issues with these patients. As well as any anti-Ach agents such as Neostigmine and Glycopyrrolate(I think(. I am not sure if this patient has Myasthenia Gravis. It is my understanding that it is a motor disorders only. I will need to check this. Gillian Barre Syndrome (GBS) is an autoimmune disorder as well. Typically triggered by a prodromal (...nice big word drop eh?...)viral or bacterial infection. It causes demylenation on the motor and sensory neurons. Loss of the myelin sheaths causes conduction on action potentials to slow at first the stop. Therefore, the longest motor and sensory axons are effected first. The longest ones inervate the legs. This is why weakness and numbness start there and marches upwards more myelin is lost. Pardon any typos. I am knocking this off at work when I should be working.... =) Cheers
mobey Posted May 4, 2011 Author Posted May 4, 2011 (edited) This is GBS. I agree the numb tongue is not a common beginning symptom, but that is how it manifested in this patient. This pt was intubated for 1 night, and has since been showing daily improvement slowly regaining neurological function. It is planned she will be transfered to a rehab clinic this week and hopes to be home later in the month. BTW; The neurologist pronounces it Jullian Bar-eh..... I have always pronounced it as Gee-on Bar-eh Anyone know which is proper? Edited May 4, 2011 by mobey
DartmouthDave Posted May 4, 2011 Posted May 4, 2011 This is GBS. I agree the numb tongue is not a common beginning symptom, but that is how it manifested in this patient. This pt was intubated for 1 night, and has since been showing daily improvement slowly regaining neurological function. It is planned she will be transfered to a rehab clinic this week and hopes to be home later in the month. BTW; The neurologist pronounces it Jullian Bar-eh..... I have always pronounced it as Gee-on Bar-eh Anyone know which is proper? Hello, I have always heard it pronounced with a 'G' not a 'J'. Was the Neurologist British and wearing an ascot? =) Cheers
DwayneEMTP Posted May 4, 2011 Posted May 4, 2011 Holy shit...what made you think that this would be too simple for many?? I couldn't find one single worthwhile thing to add to this thread, but much less find this call simple! Thanks for sharing man..great scenario..we've had some good ones lately! I miss them! Dwayne
mobey Posted May 4, 2011 Author Posted May 4, 2011 Holy shit...what made you think that this would be too simple for many?? I couldn't find one single worthwhile thing to add to this thread, but much less find this call simple! Thanks for sharing man..great scenario..we've had some good ones lately! I miss them! Dwayne I guess my hindsight led me astray. When her fingers went numb, I thought.... well that is wierd, lots of possibilities - ALS, MS, tumor etc. Then when her weakness started I thought "OK Must be MS or tumor. When she was diagnosed I thought to myself "Well duhh, young person... gradual weakness/parastesia.... of course GBS" perhaps it was not so obvious after all, and I can stop kicking myself.
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