A 34-year-old lady presented with generalised weakness of body, indistinguishable from myasthenia gravis within 24 hours of a wasp sting. [ncbi.nlm.nih.gov]

In developing its educational products ATSDR has made a diligent effort to ensure the accuracy and the currency of the presented information. [atsdr.cdc.gov]

Presentation History Weakness : In 60% of cases, onset occurs approximately three weeks after a viral illness. The condition usually presents with an ascending pattern of progressive symmetrical weakness, starting in the lower extremities. [patient.info]

It usually affects the ocular muscles first and presents as ophthalmoplegia, ataxia, and areflexia. Anti-GQ1b antibodies are present in 90% of cases. [guillain-barre.co.uk]

Congenital disorder of the brain related to paralysis is present in cerebral palsy. [health-tutor.com]

• Fatigue

  Physical effects The person may experience fatigue, poor balance, slurred words, a weak grip, tripping when walking, or other minor symptoms. Sometimes this stage occurs before a diagnosis is made. [mda.org]

  After aprodromal phase (paraesthesias, restlessness, irritaility, fatigue, and myalgias) neurological symptoms will start with paralysis of the lower extremities. The deep tendon reflexes are weak or absent. [cvbd.org]

  We have to make a clear distinction between muscle fatigue and muscle weakness. While fatigue is changing over rest, weakness is not. [shortnessofbreath.it]

  if you suspect that there is residual fatigue of the inspiratory muscles, take a day off. keep an IMT diary. [physio-pedia.com]

  It is the principal muscle of respiration, is innervated by the phrenic nerves that arise from the nerve roots at C3 through C5, and is primarily composed of fatigue-resistant slow-twitch type I and fast-twitch type IIa myofibers. • What is the most characteristic [blogs.nejm.org]

• Pain

  "You will feel the shock but you wont remember any of the pain" C. "The medications you receive will reduce any pain and help you to not remember the procedure" D. [quizlet.com]

  Pain : neuropathic pain may develop, particularly in the legs. Back pain may be another feature. Reflexes : these may be reduced or absent. Sensory symptoms : these can include paraesthesiae and sensory loss, starting in the lower extremities. [patient.info]

  Loss of pain and temperature sensation is usually mild. In fact, pain is a common symptom in GBS, presenting as deep aching pain usually in the weakened muscles, which patients compare to the pain from over exercising. [guillain-barre.co.uk]

  1-4 Case Report A 90-year-old female presented with epigastric pain and coffee-ground emesis. [acgcasereports.gi.org]

  Disturbing, but not painful. Most people can “let go.” However, strong involuntary movements can cause injuries. 6-25 milliamps (women)† Painful shock. Muscular control is lost. This is the range where “freezing currents” start. [elcosh.org]

• Falling

  You may lose your balance and fall, which can cause injury or even death if you fall into machinery that can crush you. High voltages can also cause severe burns (as seen on pages 9 and 10). [elcosh.org]

  There is a fall in serum potassium preceding weakness, but in some patients the level may never fall below normal. 54 Johnsen's series of provocative studies recorded an episode of weakness of 11 hours duration provoked by a 0.3 mmol/L fall in the serum [hkpp.org]

  If a fall occurs, the person may not be able to stand back up alone. Driving is relinquished. Weakness in swallowing muscles may cause choking and greater difficulty eating and managing saliva. [mda.org]

  Other causes of nerve damage fall into group of polyneuropathies. Polyneuropathy usually does not lead to significant locomotive disruption; it is rather associated with unpleasant tingling, burning or pain in the peripheral parts of the body. [health-tutor.com]

  Risk for falls related to decreased sensorium for 2 to 4 days postoperatively D. Impaired gas exchange due to the CNS depressant effect of general anesthesia A patient is recovering from general anesthesia. [quizlet.com]

• Collapse

  J98.19 Other pulmonary collapse J98.2 Interstitial emphysema J98.3 Compensatory emphysema J98.4 Other disorders of lung J98.5 Diseases of mediastinum, not elsewhere classified J98.59 Other diseases of mediastinum, not elsewhere classified J98.6 Disorders [icd10data.com]

  - Cardiovascular collapse may occur. - Several conditions may increase sensitivity to NMBDs. [quizlet.com]

  SDB in neuromuscular disease mainly comprises alveolar hypoventilation but upper airway collapse may also occur because pharyngeal muscle tone is impaired by both neuromuscular weakness and sleep. [clinicaltrials.gov]

  Discussion Rapid collapse of alveoli on induction of anesthesia and more widespread closure of airways seem to explain the oxygenation impairment and may also contribute to postoperative pulmonary infection. [link.springer.com]

  The buildup of mucus can result in atelectasis ((at-uh-LEK-tuh-sis), which is a collapse of all or a portion of the lung. [msktc.org]

• Swelling

  Lupus: This is an autoimmune disease that can lead to inflammation, swelling, and damage to joints, skin, kidneys, blood, the heart, and lungs. [medicalnewstoday.com]

  You will be told to rest the injured area to reduce pain and swelling. If the strain is in the leg or foot area, you may need to use crutches. [en.wikibooks.org]

  Vomiting, diarrhoea, constipation and abdominal swelling may also occur. The disease can progress to weakness in the neck and arms, after which the respiratory muscles and muscles of the lower body are affected. [who.int]

  Smoking causes the lining of the upper airway to swell, alcohol and sedative drugs cause the muscles in the back of the upper airway to relax, and excessive weight decreases the size of the upper airway. [gbppa.org]

  R1086C; R1086H; R1239G; R1239H; Provoked by anesthesia, drugs, alcohol, hypokalemia, intense exercise or fasting, worsens with age; causes fatigue & muscle pain and tenderness, damage to muscle sarcolemma, failure of energy supply within muscle cell, swelling [hkpp.org]

• Dyspnea

  Patients usually are asymptomatic at rest but may experience dyspnea upon exertion and may have a decrease in exercise performance. [12] If the patient has an underlying lung disease, dyspnea may occur at rest. [emedicine.medscape.com]

  When symptomatic, the following may be noted : Difficulty breathing when physically active (exertional dyspnea). Reduced endurance. Mild orthopnea – difficulty breathing when lying down. [healthhype.com]

  SDB often starts long before exertional dyspnea or orthopnea develop. [clinicaltrials.gov]

  Dysfunction of one or both hemidiaphragms is an underdiagnosed cause of dyspnea. [blogs.nejm.org]

  Shortness of breath on exertion (dyspnea) Need to sleep sitting up (orthopnea) Retention of carbon dioxide (CO 2 ) morning headaches poor concentration and impaired intellectual function Sleep disturbances not feeling rested in the morning sleepiness [gbppa.org]

• Vomiting

  […] glands (tearing) Urination : relaxation of the internal sphincter muscle of urethra, and contraction of the detrusor muscles Defecation Gastrointestinal distress : Smooth muscle tone changes causing gastrointestinal problems, including cramping Emesis : Vomiting [en.wikipedia.org]

  Vomiting, diarrhoea, constipation and abdominal swelling may also occur. The disease can progress to weakness in the neck and arms, after which the respiratory muscles and muscles of the lower body are affected. [who.int]

  Severe headache in Guillain-Barré syndrome is rare; an initial episode of a headache, vomiting, fever and back and limb pain is usually followed by paralysis. [guillain-barre.co.uk]

  […] peripheral demyelination or axonal loss have been postulated. 10 Back to Top Clinical Presentation Systemic Signs and Symptoms Like most viral illnesses, common complaints include fever, fatigue, myalgias, and gastrointestinal symptoms such as nausea and vomiting [clevelandclinicmeded.com]

  They compress the abdominal viscera and are active in coughing, straining, and vomiting. Muscular control of expiration is important in speaking and singing. Mediastinum The mediastinum is defined as the interval between the two pleural sacs. [dartmouth.edu]

• Diarrhea

  Strongyloides stercoralis hyperinfection in a malnourished 6-year-old boy was characterized by severe diarrhea, dehydration and marked hypokalemia, followed by acute respiratory failure due to respiratory muscle paralysis, and cardiac arrest. [ncbi.nlm.nih.gov]

  He continued to have severe diarrhea and again developed marked hypokalemia with respiratory muscle paralysis, abdominal distention, and cardiac arrhythmias with cardiac arrest episodes. [ajtmh.org]

  […] loss have been postulated. 10 Back to Top Clinical Presentation Systemic Signs and Symptoms Like most viral illnesses, common complaints include fever, fatigue, myalgias, and gastrointestinal symptoms such as nausea and vomiting, abdominal pain, and diarrhea [clevelandclinicmeded.com]

  If no improvement is apparent after four to five oral doses, or if nausea or diarrhea occurs after oral KCl intake, IV administration of KCl is necessary. [hkpp.org]

• Nausea

  HEAVY DUTY Guillain-Barré syndrome is an acute, inflammatory, postinfectious polyneuropathy marked by a prodromal malaise with nausea, vomiting, headache, fever (may or may not be present) and joint pain. [guillain-barre.co.uk]

  In some patients, nonspecific GI symptoms such as heartburn, regurgitation, nausea, and epigastric pain can also develop. [9] In bilateral diaphragmatic paralysis, additional clues to diagnosis include dyspnea further exacerbated in a swimming pool or [emedicine.medscape.com]

  […] several days. 10–13 Table 1: Frequency of Systemic Signs and Symptoms of WNV Infection Sign or Symptom Jeha, et al Pepperell, et al Nash, et al Sejvar, et al Total Number of patients 23 64 59 16 162 Fever 100% 95% 90% 100% 94% Fatigue 74% — — — 74% Nausea [clevelandclinicmeded.com]

  If no improvement is apparent after four to five oral doses, or if nausea or diarrhea occurs after oral KCl intake, IV administration of KCl is necessary. [hkpp.org]

• Abdominal Pain

  35% — — 31% 33% Rash 26% 27% 19% — 24% Myalgia 22% 55% — 69% 50% Abdominal pain 17% — 7% — 29% Diarrhea 17% 34% — — 30% Jeha LE, Sila CA, Lederman RJ, et al: West Nile virus infection: A new acute paralytic illness. [clevelandclinicmeded.com]

  […] with abdominal pain, seizures, psychosis vasculitis neuropathy poliomyelitis with fever and meningeal signs CMV polyradiculitis in immunocompromised patients critical illness neuropathy myasthenia gravis poisonings with organophosphate, poison hemlock [guillain-barre.co.uk]

• Hypersalivation

  ^ [ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421825 "Symptoms of OP poisoning include, but are not limited to: miosis, sustained muscle contraction, twitching, hypersalivation, excessive sweating, fainting, vomiting, respiratory depression, and [en.wikipedia.org]

• Hypotension

  - Hypotension (blockade of autonomic ganglia). - Tachycardia (blockade of muscarinic receptors) - Hypotension (release of histamine). - Effects vary according to site. [quizlet.com]

  Signs and Symptoms Muscarinic signs (SLUDGE) salivation, lacrimation, urination, diaphoresis, gastrointestinal upset, emesis and progressing to bronchospasm, bronchorrhea, blurred vision, bradycardia or tachycardia, hypotension, confusion, and shock. [openanesthesia.org]

  Exposure to excessive amounts of benzyl alcohol has been associated with toxicity (hypotension, metabolic acidosis), particularly in neonates, and an increased incidence of kernicterus, particularly in small preterm infants. [drugs.com]

  Hypotension or hypertension. Thromboembolism, pneumonia, skin breakdown. Cardiac arrhythmia. Ileus. Aspiration pneumonia. Urinary retention. Psychiatric problems - eg, depression, anxiety. [patient.info]

  Dysautonomia, often causing profound swings in blood pressure (hypotension alternating with hypertension), are often conspicuous in patients with Guillain-Barré. [guillain-barre.co.uk]

• Tachycardia

  Tachycardia and mydriasis must not be used to limit or to stop subsequent doses of atropine. The main concern with OP toxicity is respiratory failure from excessive airway secretions. [openanesthesia.org]

  Tachycardia D. Seizure activity E. Muscle rigidity [quizlet.com]

  According to the International Programme on Chemical Safety, nicotine causes constriction of the peripheral blood vessels along with tachycardia, or a rapid heart beat, as well as an increase in blood pressure. [livestrong.com]

  Malignant hyperthermia frequently presents as intractable spasm of the jaw muscles ( masseter spasm) which may progress to generalized rigidity, increased oxygen demand, tachycardia, tachypnea, and profound hyperpyrexia. [rxlist.com]

  Notably, hypertension and tachycardia are also an indication of awareness and/or pain. GBS is a rare inflammation of the nerves, caused by the patient's body producing antibodies against the peripheral nerves. [guillain-barre.co.uk]

• Muscle Spasm

  Spasm of the muscles of the throat can make swallowing impossible, whereas the muscles of the larynx or of the chest wall can be thrown into such violent spasm that breathing is impossible and life is threatened. [britannica.com]

  This binding action can be agonistic (stimulatory), in which case the impulse is still sent: venoms that act in this way can overstimulate neurons, causing muscle spasms (tetany) and an increased heart rate. [bigpictureeducation.com]

  […] of the pupillary constrictor muscles Muscle spasm : stimulation of skeletal muscle (due to nicotinic acetylcholine receptor stimulation) Treatment [ edit ] Some elements of the cholinergic crisis can be treated with antimuscarinic drugs like atropine [en.wikipedia.org]

  Succinylcholine should be employed with caution in patients with fractures or muscle spasm because the initial muscle fasciculations may cause additional trauma. [rxlist.com]

  Involuntary Muscle Movement [ edit ] Spasms When Smooth and skeletal muscles go through multiple spasms it is referred either as seizure or convulsion. [en.wikibooks.org]

• Muscle Cramp

  Early stages Muscles Muscles may be weak and soft, or they may be stiff, tight, and spastic. Muscle cramping and twitching ( fasciculation ) occurs, as does loss of muscle bulk ( atrophy ). [mda.org]

• Sweating

  Other symptoms include increased sweating, salivation, bronchial secretions along with miosis (constricted pupils). This crisis may be masked by the concomitant use of atropine along with cholinesterase inhibitor in order to prevent side effects. [en.wikipedia.org]

  Autonomic symptoms : involvement of the autonomic system may present, with reduced sweating, reduced heat tolerance, paralytic ileus and urinary hesitancy. Severe autonomic dysfunction may occur. [patient.info]

  - A genetically linked major adverse reaction to general anesthesia characterized by a rapid rise in body temperature, as well as tachycardia, tachypnea, muscle rigidity, and sweating. - Associated with the use of volatile inhalational anesthetics as [quizlet.com]

  These rami contain motor fibers to muscles, sensory fibers from skin and deep tissues, and postganglionic sympathetic fibers to blood vessels, sweat glands, and arrector pili muscles (fig. 20-4 ). [dartmouth.edu]

• Pruritus

  Adverse events may also accompany GBS which may include mild-to-moderate migraine attacks, chills, chest discomfort, fatigue, fever rarely, nausea, wheezing, dizziness, rashes, pains, and tenderness at injection site with increased risk of urticaria, pruritus [guillain-barre.co.uk]

• Increased Sweating

  Other symptoms include increased sweating, salivation, bronchial secretions along with miosis (constricted pupils). This crisis may be masked by the concomitant use of atropine along with cholinesterase inhibitor in order to prevent side effects. [en.wikipedia.org]

• Headache

  When the reactive inflammatory processes are restricted to the meninges, an aseptic meningitis with headache as the chief manifestation results. [clevelandclinicmeded.com]

  Severe headache in Guillain-Barré syndrome is rare; an initial episode of a headache, vomiting, fever and back and limb pain is usually followed by paralysis. [guillain-barre.co.uk]

  Poor respiration may cause fatigue, fuzzy thinking, headaches, and susceptibility to pneumonia. (Respiratory insufficiency is a leading cause of death in ALS.) Speech, or eating and drinking by mouth, may not be possible. [mda.org]

  Bilateral Rapid shallow breathing Difficulty breathing even at rest Pronounced orthopnea Anxiety Disturbed sleep Fatigue Morning headache Clinical examination reveal absence of or severely dulled breathing sounds, inward movement of the abdomen when inhaling [healthhype.com]

  - Acute pain related to the adverse effect of spinal headache from epidural anesthesia. - Deficient knowledge related to lack of information about anesthesia. - Risk for injury related to the impact of any form of anesthesia on the CNS (CNS depression [quizlet.com]

• Seizure

  ^ [ https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5421825 "Symptoms of OP poisoning include, but are not limited to: miosis, sustained muscle contraction, twitching, hypersalivation, excessive sweating, fainting, vomiting, respiratory depression, and seizures [en.wikipedia.org]

  Intubation may be necessary in cases of respiratory distress due to laryngospasm, bronchospasm, bronchorrhea, or seizures. Immediate aggressive use of atropine may eliminate the need for intubation. [openanesthesia.org]

  Although the tremors can be mistaken for seizure activity in severely affected patients, focal motor seizures have rarely also been described. 10–13 Back to Top Diagnosis Laboratory Findings Complete blood counts on admission usually show no major abnormalities [clevelandclinicmeded.com]

  Seizure activity E. Muscle rigidity [quizlet.com]

  Involuntary Muscle Movement [ edit ] Spasms When Smooth and skeletal muscles go through multiple spasms it is referred either as seizure or convulsion. [en.wikibooks.org]

• Vertigo

  Early symptoms include marked fatigue, weakness and vertigo, usually followed by blurred vision, dry mouth and difficulty in swallowing and speaking. Vomiting, diarrhoea, constipation and abdominal swelling may also occur. [who.int]

• Slurred Speech

  Severe slurred speech and difficulty managing secretions are also signs of potential impending MG crisis. [myasthenia.org]

Cardiac evaluations using serial ECGs with measurements of the QTc interval are essential and should be performed on all patients undergoing workup for periodic paralysis. 23, 24, 25 References 1. [hkpp.org]

• Atelectasis

  Causative mechanisms to atelectasis and airway closure seem to be loss of respiratory muscle tone and gas resorption. [link.springer.com]

  A: Chest radiographs may reveal elevated hemidiaphragms and basal subsegmental atelectasis. Although chest radiography is a reasonably sensitive tool for detecting unilateral diaphragmatic paralysis (90%), its specificity is unacceptably low (44%). [blogs.nejm.org]

  The buildup of mucus can result in atelectasis ((at-uh-LEK-tuh-sis), which is a collapse of all or a portion of the lung. [msktc.org]

  On the other hand patients with reduced ability of cough are also at risk of developing pulmonary atelectasis and recidive pulmonary infection. Effective cough can only be produced with a MEP higher than 50–60 cm H 2 0 ( 4 ). [shortnessofbreath.it]

• Hypercapnia

  Validation has to be carried out with regard to both daytime hypercapnia and nocturnal retention of carbon dioxide because the latter often represents the earliest manifestation of respiratory muscle weakness. [clinicaltrials.gov]

  Do not wait for ABGs to show hypoxemia or hypercapnia. These are late developing signs that appear only immediately prior to respiratory arrest in MG patients. [myasthenia.org]

  At the first signs of nocturnal hypercapnia, the patient should be offered NIV therapy rather than waiting until the hypercapnia extends into the daytime period. [shortnessofbreath.it]

  Instead, the CO 2 accumulates (called hypercapnia), and thus there is decreased room in the alveoli for oxygen. Hypercapnia and decreased oxygen saturation are the hallmarks of underventilation or hypoventilation. [gbppa.org]

  […] exercised in the following events: history of spontaneous pneumothorax traumatic pneumothorax that has not fully healed burst eardrum or other conditions of the eardrum unstable asthma with abnormally low perception of dyspnoea Precautions Minimise hypercapnia [physio-pedia.com]

The treatment of botulism is administration of antitoxin followed by supportive care as well as intensive physical therapy. 5 Overall, with prompt recognition and treatment, botulism has a relatively low mortality rate of 5 This exceedingly rare case [acgcasereports.gi.org]

Treatment With myasthenia gravis, the limbs can weaken. There is no cure for myasthenia gravis, but treatment with immunosuppressants or cholinesterase inhibitors can help control symptoms. [medicalnewstoday.com]

Botox treatments employ the purified and heavily diluted botulinum neurotoxin type A. [who.int]

Treatment Termination of the exposure including removing all soiled clothing. Gently cleanse with soap and water to hydrolyze organophosphate solutions. Airway control and adequate oxygenation. [openanesthesia.org]

All four patients responded well to treatment. [jpma.org.pk]

A decrease to less than 20% of predicted normal is associated with a poorer prognosis. [patient.info]

A positive correlation exists between MIP and 6MWT, indicating that respiratory muscle training (RMT) can directly influence exercise tolerance in stroke survivors and contribute to better prognosis and survival. [pnmedical.com]

Long-term prognosis for clinical West Nile virus. Emerg Infect Dis. 10: 2004; 1405-1411. Back to Top [clevelandclinicmeded.com]

Prognosis Approximately 80% of patients have a complete recovery within a few months to a year, although minor findings may persist, such as areflexia. [guillain-barre.co.uk]

Year introduced: 1973(1968) PubMed search builder options Subheadings: analysis anatomy and histology blood cerebrospinal fluid chemically induced classification complications congenital diagnosis diagnostic imaging drug therapy enzymology epidemiology etiology [ncbi.nlm.nih.gov]

The approach to the patient with hypokalemic paralysis includes a vigorous search for the underlying etiology and potassium replacement therapy. Further therapy depends on the etiology of the hypokalemia. [jpma.org.pk]

Etiology [ edit ] Cholinergic crisis, sometimes known by the mnemonic "SLUDGE syndrome", [2] can be a consequence of: Contamination with - or excessive exposure to - certain chemicals including: nerve agents, ( e.g. sarin, VX, Novichok agents ). organophosphorus [en.wikipedia.org]

A higher number of patients in the cisatracurium group had pneumonia as the primary etiology of ARDS, while those who received the placebo had more intra-abdominal sepsis as the source. [sccm.org]

It is considered significant when the distance between the surface of the anterior wall of the thorax and the deepest part of the depression is greater than 3 cm. 21 Its etiology is unknown, although a close relation to the Marfan syndrome has been found [archbronconeumol.org]

Year introduced: 1973(1968) PubMed search builder options Subheadings: analysis anatomy and histology blood cerebrospinal fluid chemically induced classification complications congenital diagnosis diagnostic imaging drug therapy enzymology epidemiology [ncbi.nlm.nih.gov]

Epidemiology The incidence of typical GBS in Europe is 1.2-1.9 per 100,000 [ 3 ]. There is an increased incidence in males. Peak ages are 15-35 years and 50-75 years. [patient.info]

Epidemiology and outcome of acute lung injury in European intensive care units. Results from the ALIVE study. Intensive Care Med. 2004;30:51-61. 2. Ranieri VM, Rubenfeld GD, Thompson BT, et al. [sccm.org]

Back to Top Epidemiology Since its first isolation in the West Nile district in Uganda in 1937, WNV has become endemic throughout Africa and areas of the Middle East, where the prevalence of WNV antibody among children is 3.5% to 8%. 1–3 Since the mid [clevelandclinicmeded.com]

Following a brief examination of the force these muscles are required to exert in normal conditions, we review the pathophysiology of some characteristic alterations brought about by a) chest wall diseases such as kyphoscoliosis; b) other diseases involving [archbronconeumol.org]

Hypokalemic paralysis: A review of the etiologies, pathophysiology and therapy, Am. J. Emerg. Med., 1992; 10:143-8. 3. Gabow, P.A. Disorders associated with an altered anion gap. Kidney Int., 1985;27:472-483. 4. Battle, D. Renal tubular acidosis. [jpma.org.pk]

Patients seldom recall a specific mosquito bite, but they are often self-reported active persons with significant outdoor—and therefore mosquito—exposures. 12 Back to Top Pathophysiology WNV is a member of the Japanese encephalitis complex of viruses [clevelandclinicmeded.com]

Prevention Prevention of foodborne botulism is based on good practice in food preparation particularly during heating/sterilization and hygiene. [who.int]

Prevention - Your first defense is to do whatever you can to prevent respiratory health problems. Here is a checklist. Do not smoke and stay away from secondhand smoke! Exposure to tobacco smoke is the worst thing you can do for your health. [msktc.org]

[…] chemically induced classification complications congenital diagnosis diagnostic imaging drug therapy enzymology epidemiology etiology genetics history immunology metabolism microbiology mortality nursing parasitology pathology physiology physiopathology prevention [ncbi.nlm.nih.gov]

Prevention MG cannot be prevented. However, a person can take steps to stop a flare-up of symptoms or prevent them from developing complications. [medicalnewstoday.com]

"They will give you enough pain medication to prevent you from feeling it" The nurse is administering an NMBD to a patient during a surgical procedure. [quizlet.com]