Presented by: Estrada, Jay Mart A. Layno, Jaclyn C. Martinez, Gladys E. Ortizano, Monroe S. Ramos, Maria Kristina P. Sta.

Ana, Yra Gwyneth Virginia P.

Presented to: Staff of Davao Medical Center

Myasthenia Crisis is an exacerbation of Myasthenia Gravis. It is characterized by severe generalized muscle weakness and respiratory and bulbar weakness that may result in respiratory failure. Myasthenia Crisis is the life threatening complication of

Myasthenia

Gravis-

an

autoimmune

disorder

affecting

the

myoneural junction, characterized by varying degrees of weakness of the voluntary muscles.

Statistics:
Affects 1 per 250,000 persons through out the world.
* 15- 20% suffers to Myasthenia Crisis
* 65% pts, primary cause is infection

13, 600 people is USA who are reported to have MG. 4, 312 reported cases in the Philippines.

Health of Present Illness Time 3 days PTA Event Productive cough and colds Actions Didnt take any medications for cough Increased fluid intake

Ptosis

Wore sunglasses

9 hrs PTA

Sudden onset of dyspnea and difficulty swallowing

Attempted to sleep but failed

Sat on orthopneic position

9:00pm

Ask her sister to massage her back and extremities, while applying Efficascent oil.

1:00 am

Able to sleep

4:00 am

Woke up due to worsening condition

Decided to seek consult

5:00am

Arrived in DMC emergency room, ambulatory

O2 inhalation @ 3Lpm/nc Venoclysis started with D5LR 1L @ 120cc Blood specimen taken Pyridostigmine 65mg/ tab Hydrocortisone 100mg IVTT given Relieved with her S/sx

9:35 am

Dyspnea reoccurred

Increased O2 inhalation to 6Lpm Pt. was relieved with her S/sx

History of Past Illness Date Event Action

April 2007

Difficulty swallowing, speaking, Inability to expectorate, easy fatigability

Sought consult @ Conpinco Clinic @ Tagum City Prescribed with unrecoilled medications & vitamins Decreased work duties from 12hrs. to 8 hrs.

May 2007

Body weakness, Ptosis & Photosensitivity

Rest Wear sunglasses

November 2007

Difficulty breathing/ dyspnea Paralysis and slurring of speech

Admitted @ DRH Intubated for 2 days NGT inserted Prescibed Pyridogtismine 65mg/tab T.i.d. & prednisone 20mg 1tab B.i.d.

February 2008

Dysphagia & Ptosis

Admitted @ DMC Discharged after 3 days

Mr. Z

Paternal

Ms. Z

Maternal
Mr. Y

Ms. Y

Mr. A Mr. X Ms. B

Mr. C Ms. D

Ms. X

?
Mr. E, 51 Mr. F, 49

?
Mr. G, 47

? ?
Mr. J, 43 Mr. K, 37

?
Mr. L, 31 Ms. Flor, 29

?
Ms. P, 27

Mr. H, 45

Ms. S, 27

-Male -female -Unrecalled gender - Pt. -CAP -HTN -Alcoholic drinker

-Neonatal -unrecalled cause of death death -Drug-induced -Unrecalled # mental illness of siblings

-MG

-Smoker

-Insomnia

? - No known Info.