Myasthenia gravis is a disease that manifests itself in the form of weakness and fatigue of the muscles. Paralysis often occurs due to muscle weakness. Most often, the disease affects the muscles of the eyes, face, tongue, lips, throat, neck and larynx. The disease is prone to progression, so it is necessary to have an idea about the symptoms and causes of myasthenia gravis. It also needs to be identified as soon as possible. In some people, it is clearly visible in external manifestations, but in any case, a diagnosis is required. One of her methods is the prozerin test.
Forms of myasthenia gravis
Before answering the question of what it is, a proserine test, you need to describe the myasthenia gravis itself. There are three main forms of this disease:
- Myasthenia gravis. Characterized by damage to the eye muscles (may be common in older men).
- Bulbar form. Most often it is a further development of the eye. Characterized by damage to the bulbar groupnerves (glossopharyngeal, hypoglossal).
- Generalized form. It is a combination of the two previous symptoms, but with damage to the skeletal muscles.
Thus, with local forms (eye and bulbar), weakness of individual muscle groups is observed, with a generalized form, the muscles of the trunk or limbs suffer.
Symptoms
The first step to diagnosing myasthenia gravis is to identify its symptoms. The main one is high muscle fatigue during prolonged stress. As a rule, after a few hours of rest, muscle function is restored.
A more specific list of symptoms is as follows:
- Voice fades out during a call.
- Problems chewing and swallowing food.
- Fatigue during movements, often not even very intense (walking, combing).
- Shambling walk.
- Dropping eyelids.
The danger of myasthenia gravis lies in the apparent "routine" of symptoms, which often people do not pay attention to. Therefore, in many cases, myasthenia gravis is diagnosed when it is already becoming severe. Therefore, abnormally high fatigue, muscle weakness and flaccidity are potential signs of the disease and require an examination to confirm or refute the diagnosis.
Myasthenic crisis
So in medicine is called the sudden onset of muscle weakness, often reaching paralysis. The signs of a crisis are as follows:
- Breathat first shallow and frequent, after intermittent and rare. In this case, the patient is seized with anxiety, and his face first turns red, then blue. Complete respiratory arrest with fatal outcome may occur.
- The pulse quickens and blood pressure rises. Then the pulse becomes rarer and weaker, and then thready.
- There is heavy sweating and salivation.
In the absence of timely assistance, oxygen starvation and brain damage may occur.
It is very important to distinguish a myasthenic crisis from a cholinergic one. The latter is similar to myasthenic, but occurs due to an overdose of drugs for myasthenia gravis.
Causes of disease
Despite the fact that the symptoms of myasthenia gravis are known, the causes of its occurrence have not been fully established. Allocate congenital and acquired myasthenia gravis. Known cases of the combination of this disease with pathologies of the thymus gland indicate the involvement of this organ in the pathological process. Also, myasthenia gravis is observed in diseases of the nervous system, cancer of the lungs, breast, ovaries, prostate.
The essence of the pathology is the disruption of the neuromuscular connections. Muscles are set in motion by nerve impulses, which are transmitted with the help of neurotransmitters. During myasthenia, antibodies are produced that block or damage the receptors for essential neurotransmitters. Therefore, much less nerve signals reach the muscles, which leads to weakness.
Antibodies that damage neurotransmitter receptors are thought toproduces an inflamed thymus (thymus gland).
Myasthenia gravis can further worsen the following factors:
- Fatigue.
- Diseases.
- Stress.
- Drugs that affect the functioning of nerve receptors.
Diagnosis of myasthenia gravis
If the above symptoms appear, you should consult a neurologist. He will conduct an examination, identify complaints and signs that could go unnoticed. However, the use of a proserine test is necessary, since it is difficult to identify the disease with a simple examination.
What is Prozerin, general information
"Prozerin" is a synthetic medicine. When applied, it reduces heart rate, increases the secretion of glands (salivary, sebaceous, sweat, etc.), constricts pupils, reduces pressure in the eye, tones muscles, and causes bronchospasm. It is used not only for testing for myasthenia gravis, but also in the treatment of this disease. When used in therapeutic doses, it improves the functioning of neuromuscular connections. In large doses, it can itself cause disruption of their work. Prozerin is produced in ampoules for testing, and in 15 mg capsules for administration. Available by prescription.
Performing a sample
The method of proserin test is to introduce a solution of "Proserin" under the skin. Then, after 20-30 minutes, the doctor examines the patient to determine the reaction. In the presence of myasthenia gravis, its symptoms disappear after an injection of Prozerin. If there is no effect, then it is said thatproserin test is negative. Myasthenia is absent in this case. For the test, only "Prozerin" in ampoules is used.
This procedure does not require special equipment or complex manipulations. It is enough to be able to put a simple subcutaneous injection. These are the main provisions that clearly explain how to conduct a proserine test.
Features of the use of the drug
Like any drug, Prozerin has its own indications and contraindications.
Indications:
- Myasthenia gravis.
- Paralysis
- Recovery period after encephalitis, meningitis.
- Atrophy of the optic nerve.
- Atony of the bladder and gastrointestinal tract.
- Normalization of neuromuscular connections.
Applicable to both adult and pediatric patients.
Contraindications to the use of Prozerin are:
- Hypersensitivity to the active substance.
- Epilepsy.
- Vagotomy.
- Diseases of the cardiovascular system.
- Asthma.
- Diseases of the gastrointestinal tract.
- Diseases of the genitourinary system.
- Pregnancy and lactation.
Thus, although the prozerin test for myasthenia gravis is a diagnostic tool, "Proserin" itself can be used as a medicine. It should be noted that due to the short duration of the effect, for the treatment of myasthenia "Prozerin" is used only in combination withother drugs.
Side effects
Side effects of the drug affect various organs and organ systems of the patient. The pattern of side effects is as follows:
- Digestive organs: vomiting, nausea, diarrhea, increased flatulence.
- Nervous system: headaches and dizziness, weakness and drowsiness, spasms and convulsions, blurred vision, tremors and involuntary muscle contractions.
- Cardiovascular system: cardiac arrhythmias, cardiac arrest.
- Respiratory organs: shortness of breath, bronchospasm, respiratory arrest.
- Allergies: itching, rash, anaphylactic shock.
- Other: frequent urination, excessive sweating.
What can replace prozerin sample
Although this method is extremely effective, there are others. A list of some of them is as follows:
- Electromyography. Known as the decrement test. It is a measurement of the volume of bioelectrical signals in the muscles. It is carried out before and after the prozerin test.
- Electroneurography. Checking the speed of transmission of a nerve signal to the synapse.
- A blood test for antibodies that block and damage neurotransmitter receptors.
- Study of the genotype. It is carried out to confirm or refute the hereditary nature of the disease.
- Computed tomography of the thymus. Allows you to detect changes in its size.
In addition, there are special tests to help identify the disease. They are quite simple andperformed at home. Here they are:
- You need to quickly open and close your mouth. Repeat these movements for forty seconds. In the absence of myasthenia gravis, a person manages to do a hundred or more cycles.
- Lying on your back, you need to keep your head elevated for a minute.
- You need to do twenty squats with one amplitude.
- You need to quickly squeeze and unclench the brushes. For myasthenia gravis, this exercise can lead to drooping of the eyelids.
Treatment of myasthenia gravis
Complete cure of myasthenia gravis is impossible. Therapy is reduced to the formation of a stable remission in the patient. The main task is to increase the level of the neurotransmitter acetylcholine, which ensures the transmission of a nerve impulse to the muscles. The following types of drugs are used during therapy:
- Anticholinesterase drugs. Sometimes the name AHEP is found. These drugs neutralize cholinesterase, which normally breaks down acetylcholine.
- Potassium preparations. Prolong the work of AHEP, improve muscle function.
- Cytostatics. Reduce the number of antibodies and immune cells that produce them.
- Hormone preparations. Reduce symptoms.
- Additionally, the doctor may prescribe immunoglobulins, immunosuppressants, antioxidants.
During an exacerbation of the disease, plasmapheresis, Prozerin, thymus gamma irradiation, a wider list of immunoglobulins are prescribed.
Myasthenia gravis takes a long time to heal. For therapy to lead to remission, some medications must be taken for life. During treatment, you need to constantly monitorblood pressure and blood sugar.
If there is a thymus tumor, surgery is performed.
Physiotherapy
Physiotherapy is widely used to treat myasthenia gravis. Its goal is also to improve neuromuscular connections, normalize tissue nutrition.
For the treatment of myasthenia are used:
- Current stimulation.
- Inhalation with drugs.
- Electrophoresis of drugs (most often prozerin).
- Electrostatic massage.
- Color therapy (used to influence the psyche).
- Regular massage.
During periods of remission and in the absence of myasthenic crises, spa treatment is allowed. The resorts of Crimea, Sochi are best suited.
Before conducting spa treatment, you need to make sure that the patient has no contraindications to this form of therapy.
It should be noted that none of the methods of physiotherapy can be used separately, in isolation from the main treatment.
Forecast
Despite the severity of the disease, myasthenia gravis is compatible with a comfortable and fulfilling life. For therapy to be successful, strict adherence to the regimen, which consists in the timely intake of the necessary drugs, is necessary. Non-compliance with the regime threatens with a relapse of attacks, up to the likelihood of a crisis.
Obvious is also the inadmissibility of any self-treatment. When the first signs of myasthenia gravis appear, you should immediately visit a neurologist!
Prevention
If a person is diagnosed"myasthenia gravis", he is contraindicated in heavy physical exertion and prolonged exposure to the sun. Food should be low in calories. It is necessary to take drugs both directly against myasthenia gravis and supporting immunity (drugs to support immunity are recommended only during remission). Antipsychotics, diuretics, tranquilizers and some groups of antibiotics are contraindicated.
The best form of prevention of myasthenia gravis, like any other disease, is to take care of your he alth. Remember: in no case should you self-medicate, and if you have he alth problems, you should immediately go to the doctor!
Conclusion
Due to the non-obviousness of the symptoms and causes of myasthenia gravis, fast and effective methods for diagnosing this pathology are required. In addition, when it is detected, complex therapy is necessary. Prozerin test is the fastest, easiest and most reliable way to diagnose myasthenia gravis. "Prozerin" itself is an integral element of the complex therapy of the disease.
