Myasthenia Gravis : An Autoimmune Neuromuscular Disorder

1012 Words5 Pages
Myasthenia Gravis (MG) is an autoimmune neuromuscular disorder meaning grave muscular weakness. Symptoms associated with myasthenia gravis include painless, fluctuating, and fatigable weakness involving specific muscle groups. Weakness is usually least in the morning and progresses as the day continues especially with prolonged muscle use. Double vision and drooping eyelids is usually the first symptom complaint from patients with MG. The patient may complain of difficulty with speech, chewing, swallowing, or breathing. Initial symptoms of difficulty chewing, swallowing, or speaking is reported in 16% of patients. Weakness can also be present in the arms or legs. Prevalence of MG is currently 20/100,000 in the United States. The…show more content…
Patients with MG are at a high risk for silent aspiration. Literature has demonstrated that silent aspiration occurs in approximately 50% of those with MG who aspirate (Higo, Nito, Tayama, 2005). Colton-Hudson reported silent aspiration in 4 out of 7 patients (2005). Kluin et al studied 8 elderly men with MG and found silent aspiration in 5 out of 8 patients (1996).Due to the high incidence of silent aspiration instrumental evaluation of the swallow is suggested for patients with MG. In most instances cholinesterase inhibitor medication provides improvement in the patient’s swallow. Colton et al reports that active exercise to maximize the strength of the oropharyngeal muscles are generally limited by fatigability and not recommended for dysphagia associated with MG (2002). Chewing and swallowing functions may be improved by the administration of cholinesterase inhibitor medication one hour prior to the meal. Speech-language pathologist can educate patients on taking medication in conjunction with meal times. Other compensatory strategies can be implemented following instrumental swallowing evaluation. The swallowing quality of life scale (SWAL-QOL) could be used for patient reported measure of functioning for dysphagia. The SWAL-QOL has demonstrated strong internal consistency and strong test re-test reliability (McHorney et al, 2002). This test would be beneficial for intervention planning because it
Open Document