Treatments for Neonatal myasthenia
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Book Excerpts: Treatment of Neonatal myasthenia
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Seizures – Neonatal:
Treatment
(In A Page: Pediatric Signs and Symptoms)
-
Evaluate and secure airway, breathing, and circulation
–Benzodiazepines or phenobarbital infused
intravenously can stop the seizures
-
If there is reason to suspect hypoglycemia, even if blood glucose level cannot be quickly established, treat with glucose intravenously
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Treat hypocalcemia with calcium gluconate
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Treat hypomagnesemia with magnesium sulfate
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Meningitis and HSV encephalitis require intravenous antibiotics and acyclovir, respectively
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Depending on the etiology, the infant may stay on phenobarbital for varying duration of time
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Glucose transporter deficiency can be treated with ketogenic diet
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For pyridoxine deficiency, pyridoxine 50–100 mg injected intravenously during an EEG recording can be both diagnostic and therapeutic
» READ BOOK EXCERPT ONLINE »
Source: In A Page: Pediatric Signs and Symptoms, 2007
Myasthenia gravis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
Treatment is symptomatic. Anticholinesterase drugs, such as neostigmine and pyridostigmine, counteract fatigue and muscle weakness and allow about 80% of normal muscle function. However, these drugs become less effective as the disease worsens. Corticosteroids may relieve symptoms. Immunosuppressants are also used. Plasmapheresis is used in severe myasthenic exacerbation.
Patients with thymomas require thymectomy, which may cause remission in some cases of adult-onset myasthenia. Acute exacerbations that cause severe respiratory distress necessitate emergency treatment. Tracheotomy, positive-pressure ventilation, and vigorous suctioning to remove secretions usually produce improvement in a few days. Because anticholinesterase drugs aren’t effective in myasthenic crisis, they’re stopped until respiratory function improves. Myasthenic crisis requires immediate hospitalization and vigorous respiratory support.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Diseases (Eighth Edition), 2005
Myasthenia gravis:
Treatment
(Handbook of Diseases)
Treatment for myasthenia gravis is aimed at relieving symptoms. Anticholinesterases, such as neostigmine and pyridostigmine, improve communication between nerve and muscle, counteract fatigue and muscle weakness, and allow about 80% of normal muscle function. However, these drugs become less effective as the disease worsens. Decreasing the immune response toward acetylcholine receptors at the neuromuscular junction is the goal of immunosuppressant therapy. Corticosteroids, azathioprine, cyclosporine, and cyclophosphamide are used in a progressive fashion (when the previous drug response is poor, the next one is used). To suppress the immune system during acute relapses, gamma globulin may also be used. Plasmapheresis is used to treat severe exacerbations or to quickly improve symptoms (for example, preoperatively).
Patients with thymomas require a thymectomy, which may cause remission in some cases of adult-onset myasthenia. Acute exacerbations that cause severe respiratory distress necessitate emergency treatment. Tracheotomy, positive-pressure ventilation, and vigorous suctioning to remove secretions usually produce improvement in a few days.
Because anticholinesterases aren’t effective in patients with myasthenic crisis, they’re stopped until respiratory function improves. Myasthenic crisis requires immediate hospitalization and vigorous respiratory support.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Diseases, 2003
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