Myasthenia gravis vs guillain-barré syndrome what’s the difference?
Myasthenia gravis vs guillain-barré syndrome what’s the difference?
Myasthenia gravis vs guillain-barré syndrome what’s the difference?
Select one (1) of the following Nursing Diagnoses:
Impaired Spontaneous Ventilation
Impaired Swallowing
Care Giver Role Strain Address the following:
Is the nursing diagnoses that you selected appropriate for the patient with a diagnosis of myasthenia gravis, Guillain-Barre syndrome or both? Explain your answer.
Provide an outcome for the nursing diagnosis that you selected making sure that is specific to the needs of the patient with myasthenia gravis or Guillain-Barre syndrome.
Identify two (2) interventions that will help your patient with myasthenia gravis or Guillain-Barre syndrome reach the outcome for the nursing diagnosis.
Myasthenia gravis (MG) is an autoimmune disorder characterized by weakness in specific muscle groups, especially the ocular and bulbar muscles. Guillain-Barré syndrome (GBS) presents with ascending paralysis and areflexia, often secondary to an infection. Several theories have been proposed regarding the etiology behind GBS, with many studies pointing to a possible autoimmune cause.
If this is in fact true, it is also possible that the two diseases may develop concurrently. While this is unusual, several recently published studies highlight such cases of concurrent MG and GBS. This co-occurrence could involve certain common proteins, as the two diseases can present somewhat similarly. This is an unusual case of a patient with no significant past medical history, presenting with generalized weakness and symptoms of new-onset diabetes, who developed bilateral ptosis, distal weakness, and areflexia while in the hospital, raising the possibility of concurrent MG and GBS. Although the diagnosis of MG was confirmed by the positive anticholinesterase antibodies and tensilon test, several features, including sudden onset of ascending paralysis and areflexia, were more common in GBS than MG. It is possible, albeit rare, that these two syndromes could have developed concurrently and that the untreated diabetes mellitus could have contributed to the neurological symptoms. This case is reported because of the rarity of its features, diagnostic and management challenges.
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Key Words: Myasthenia gravis, Guillain-Barré syndrome, Diabetes mellitus
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Introduction
Myasthenia gravis (MG) is an autoimmune disorder involving development of auto-antibodies against specific proteins in the postsynaptic membrane of the neuromuscular junction, typically against the acetylcholine receptor (AChR) or related proteins. It is characterized by weakness, often in the ocular, bulbar, limb, and respiratory muscle groups. This disorder is often insidious and, as a result, may go undiagnosed for a significant period of time until an acute exacerbation occurs [1]. While it is well known that the mechanism behind MG is autoimmune, there are several proposed etiologies for Guillain-Barré syndrome (GBS), which is also known as acute immune-mediated polyneuropathy. GBS involves ascending muscle weakness. It is usually symmetric and is accompanied by areflexia. Patients must be closely monitored, as they can quickly develop respiratory failure [2].
There is significant evidence supporting a possible autoimmune etiology for GBS [3]. If this is in fact true, it is also possible that the two diseases may develop concurrently. While this is unusual, several recently published studies highlight such cases of concurrent MG and GBS. This co-occurrence could involve certain common proteins, as the two diseases can present somewhat similarly.
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